What is Pituitary dwarfism (Growth hormone deficiency, Panhypopituitarism)

Pituitary dwarfism involves abnormally short stature with normal body proportions.

Pituitary dwarfism can be categorized as either congenital (present at birth) or acquired.

Statistics on Pituitary dwarfism (Growth hormone deficiency, Panhypopituitarism)

A study conducted in the US of 80,000 Utah school children, indicated that 555 children were below the third height percentile and had growth rates less than 5 cm/year; of these children, 33 had GHD, an incidence rate of 1 case per 3,500 children.

Worldwide estimates vary usually dude to lack of reporting and recording but estimates range from 1:30,000 to 1:1800.

Risk Factors for Pituitary dwarfism (Growth hormone deficiency, Panhypopituitarism)

Pituitary dwarfism may be associated with deficiencies of other hormones, including the following:

 

  • Thyrotropins (control production of thyroid hormones)
  • Vasopressin (controls water balance in the body)
  • Gonadotropins (control production of male and female sex hormones)
  • Adrenocorticotrophic hormone or ACTH (controls the adrenal gland and its production of cortisol, DHEA, and other hormones)

    Progression of Pituitary dwarfism (Growth hormone deficiency, Panhypopituitarism)

    A variety of genetic syndromes, a tumor in the pituitary gland, the absence of the pituitary gland, or trauma are some of the known causes of this condition, but in most cases no underlying cause of the deficiency is found.

    Growth retardation may become evident in infancy and persists throughout childhood. The “growth curve,” demonstrated by plotting sequential height measurements on a standardized growth chart, may range from flat (no growth) to very shallow (minimal growth). Normal puberty may or may not occur, depending on the degree of pituitary insufficiency (inability of the pituitary to produce adequate hormone levels other than growth hormone).

    How is Pituitary dwarfism (Growth hormone deficiency, Panhypopituitarism) Diagnosed?

    A physical examination including weight, height, and body proportions will show signs of retarded growth rate and deviation from normal growth curves.

    Tests include the following:

     

  • A determination of bone age from hand x-ray (extremity X-ray) is often recommended.
  • Measurement of growth hormone levels confirms that the disorder is caused by dysfunction of the pituitary gland.
  • Other hormone levels should be determined as lack of growth hormone may not be an isolated problem.
  • X-ray may show skull abnormalities such as small, enlarged, or empty sella or a space-occupying lesion.
  • A CT and/or MRI scan of the head may be ordered.

    Prognosis of Pituitary dwarfism (Growth hormone deficiency, Panhypopituitarism)

    Growth rates are improved in most children treated with growth hormones, although the effectiveness of treatment may decrease with prolonged treatment.

    How is Pituitary dwarfism (Growth hormone deficiency, Panhypopituitarism) Treated?

    Replacement therapy with synthetic growth hormone can be used for children with documented growth hormone deficiency. No ideal treatment schedule has yet been determined.

    If the deficiency is an isolated growth hormone deficiency, synthetic growth hormone is given alone. If the deficiency is not isolated, other hormone replacement preparations will be required as well.

    Pituitary dwarfism (Growth hormone deficiency, Panhypopituitarism) References

    [1] Pituitary dwarfism as retrieved from www.nlm.nih.gov on 30/12/2003
    [2] University of Maryland Medical Center