Symptoms:

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.

Signs and tests:

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:

• GNRH-arginine test
• Growth hormone levels in the blood
• Growth hormone stimulation test
• Insulin tolerance test (ITT, often used to diagnose adults)
• Tests to measure levels of other hormones made by the pituitary gland

Imaging or x-ray tests may include the following:

• Dual energy x-ray absorptiometry (DEXA) scans can also determine bone age.
• Hand x-ray (usually the left hand) can determine bone age. Normally, the size and shape of bones change as a person grows. These changes can be seen on an x-ray and usually follow a pattern as a child grows older.
• Measuring growth hormone and binding protein levels (IGF-I and IGFBP-3) will show whether the growth problem is caused by a problem with the pituitary gland.
• MRI of the head can show the hypothalamus and pituitary glands.