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Endocrine Disorders
Published in Praveen S. Goday, Cassandra L. S. Walia, Pediatric Nutrition for Dietitians, 2022
Lisa Spence, Nana Adwoa Gletsu Miller, Tamara S. Hannon
Deficiency in growth hormone signaling is an endocrine disorder that affects 1:4,000–1:10,000 children. Without the action of growth hormone, longitudinal growth of the bones is slow or flat and the child will not follow growth curves from age 2 onwards. Other signs and symptoms of growth hormone deficiency are abnormal levels of insulin-like growth factor and insulin-like growth factor binding protein (both which are stimulated by growth hormone), as well as overweight and delayed puberty. In cases when deficiency of growth hormone is established as the cause of short stature, and if the condition is treated early, providing growth hormone by injection is effective treatment, enabling children to reach normal height. During treatment, frequent monitoring by the medical team is important to manage side effects (e.g., headache, fluid retention, muscle and joint ache, slippage of hip bones). Evaluation during treatment is also important since many cases do not respond to growth hormone therapy.
Tumors of the Nervous System
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Hypoprolactinemia: Failure to start/maintain lactation.Hypothyroidism with low thyroid-stimulating hormone (TSH).Growth hormone deficiency.Poorly defined in adults.Hypoadrenalism.Fatigue.Postural hypotension.
Marvellous molecules
Published in Brendan Curran, A Terrible Beauty is Born, 2020
Situated at the base of the brain is a small pea-sized structure called the pituitary gland. Referred to as the ‘master gland’, it controls the body by releasing protein hormones into the bloodstream. These eventually bind to various cells throughout the body and direct them to perform numerous functions. One of the pituitary hormones regulates growth and a deficiency, though fairly rare in the population, results in stunted growth, the condition of pituitary dwarfism. In the 1950s a new therapy was developed for this condition: pituitary glands were removed from cadavers of people who willed their bodies for medical purposes and growth hormone extracted by a chemical process. When still young and growing, the patients with a growth hormone deficiency received injections of the protein at regular intervals and grew to a normal height. However, the hormone was extremely expensive because it was in such short supply.
Multifactorial influences on successful health outcomes for an adolescent with Prader-Willi syndrome: a qualitative case study
Published in Physiotherapy Theory and Practice, 2023
Nicole Campbell, Scott Van Zant, Joyce Lammers
Individuals with PWS may present with an array of symptoms that vary across the lifespan. The most common symptoms from birth through infancy include low birth weight, poor feeding with failure to thrive, and hypotonia (Cassidy, Schwartz, Miller, and Driscoll, 2012). In early childhood, common presentation often includes continued hypotonia, slowed speech development, delayed motor milestones, and cognitive impairments with an average IQ of 60 (Whittington et al., 2004). Short stature is often apparent as a result of growth hormone deficiency, with additional endocrine dysfunction including hypogonadism and hypothyroidism often diagnosed. Hyperphagia often presents as the child ages, with an average onset of 8 years, affecting approximately 84% of individuals with the diagnosis (Butler et al,, 2002). Behavioral problems frequently arise including tantrums, skin picking, and perseveration or compulsions (Angulo, Butler, and Cataletto, 2015; Bohonowych, Miller, McCandless, and Strong, 2019; Whittington et al., 2004).
Suboptimal adherence to daily growth hormone in a US real-world study: an unmet need in the treatment of pediatric growth hormone deficiency
Published in Current Medical Research and Opinion, 2021
Jane Loftus, Yong Chen, Jose Ma. J. Alvir, Lei Chi, Shibasish Dasgupta, Anu Gupta, Michael P. Wajnrajch
Pediatric growth hormone deficiency (pGHD) occurs in approximately 1 in 4000–10,000 children1–4. The main manifestation of pGHD is short stature. Diagnosis of pGHD is challenging and may include auxology, bone age radiographic assessment, measurement of insulin-like growth factor 1 (IGF-I) and IGF binding protein 3 (IGFBP-3), cranial magnetic resonance imaging (MRI), provocative growth hormone testing, and genetic testing5. Treatment of pGHD in children involves daily injections of somatropin, a recombinant human growth hormone (r-hGH), administered subcutaneously. The main goal of treatment with somatropin is to improve height velocity within 2 standard deviations of the normal population mean as an adult. Following completion of linear growth, growth hormone (GH) status should be reassessed and patients with severe GHD may be advised to continue with further treatment until adult peak bone mass has been achieved6.
Neurobiology of traumatic brain injury
Published in Brain Injury, 2021
Kajal Bagri, Puneet Kumar, Rahul Deshmukh
Head injury, other than above-discussed mechanisms, causes skull fracture, rapid bleeding, intracranial hemorrhage, and BBB damage as primary events (8). Days or months later, secondary complications arise due to edema, hypoxia, brain ischemia and intracranial pressure (Figure 6). Injury to the hypothalamus and pituitary gland leads to growth hormone deficiency (GHD), which further contributes to decreased muscle mass, increased fat mass, altered metabolic profile, decreased exercise capacity, reduced bone mineral density etc (51).TBI destroy the basal region of the right temporal lobe and the right orbitofrontal cortex, which develop the manic-like symptoms (52,53). Focal brain destruction of CNS leads to aggressive and violent behavior, which could be experienced even by minute stimuli. The patients could found upset, and hypersomnia condition could be observed after TBI.