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Panhypopituitarism; Pituitary dwarfism; Recombinant human GH (rhGH); Acquired growth hormone deficiency; Congenital growth hormone deficiency; Somatropin
Growth hormone deficiency refers to abnormally short height in childhood due to the lack of growth hormone.
See also: Short stature
Growth hormone is produced in the pituitary gland, which is located at the base of the brain.
Abnormally short height in childhood (called short stature) may occur if not enough growth hormone is produced.
Most of the time, no single clear cause of growth hormone deficiency is found.
Children with physical defects of the face and skull, such as cleft lip or cleft palate, are more likely to have decreased growth hormone levels.
Growth hormone deficiency is usually not passed from parent to child.
Although it is uncommon, growth hormone deficiency may also be diagnosed in adults. Possible causes include:
Children with growth hormone deficiency have a slow or flat rate of growth, usually less than 2 inches per year. The slow growth may not appear until a child is 2 or 3 years old.
The child will be much shorter than most or all children of the same age and gender.
Children with growth hormone deficiency still have normal body proportions, as well as normal intelligence. However, their face often appears younger than children of the same age. They may also have a chubby body build.
In older children, puberty may come late or may not come at all.
A growth chart is used to compare a child's current height, and how fast he or she is growing, to other children of the same age and gender.
A physical examination including weight, height, and body proportions will show signs of slowed growth rate. The child will not follow the normal growth curves.
Several blood tests are used to help diagnose growth hormone deficiency and its causes:
Imaging or x-ray tests may include the following:
A child's short stature will often affect self-esteem. Providing emotional support is an important part of treatment. Children may be teased by classmates and playmates. Family, friends, and teachers should emphasize the child's other skills and strengths.
Treatment involves growth hormone injections given at home. Patients may receive growth hormone several times a week or once a day.
Many children gain 4 or more inches over the first year, and 3 or more inches during the next 2 years. Then the growth rate slowly decreases.
Serious side effects of growth hormone therapy are rare. The most common side effects are:
The earlier the condition is treated, the better the chance that a child will grow to be a near-normal adult height.
Growth hormone replacement therapy does not work for all children.
If left untreated, growth hormone deficiency will lead to short stature and delayed puberty.
Growth hormone deficiency may occur with deficiencies of other hormones, including the following:
Call your health care provider if your child seems abnormally short for his or her age.
Most cases are not preventable.
Review your child's growth chart with your physician after each check-up. If your child's growth rate is dropping or your child's projected adult height is much shorter than an average height of both parents, evaluation by a specialist is recommended.
Parks JS, Felner EI. Hypopituitarism. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, Pa: Saunders Elsevier;2011:chap 551.
Reiter EO, Rosenfeld RG. Normal and aberrant growth. In: Kronenberg HM, Melmed S, Polonsky KS, Larsen PR, eds. Williams Textbook of Endocrinology. 11th ed. Philadelphia, Pa: Saunders Elsevier;2008:chap 23.
Cook DM, Yuen KC, Biller BM, Kemp SF, Vance ML; American Association of Clinical Endocrinologists. American Association of Clinical Endocrinologists medical guidelines for clinical practice for growth hormone use in growth hormone-deficient adults and transition patients - 2009 update. Endocr Pract. 2009;15:1-29.
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