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Treatment of growth hormone deficiency in children

Alan D Rogol, MD, PhD
Section Editor
Mitchell E Geffner, MD
Deputy Editor
Alison G Hoppin, MD


The importance of the pituitary gland for growth was recognized in 1886, when Marie noted the association between pituitary tumors and symptoms and signs of acromegaly [1]. The presence of a growth-promoting factor in the hypophysis was demonstrated in 1909, when Aschner demonstrated that removal of the pituitary from puppies causes severe growth retardation [2].

It was not until 1921, however, that a positive effect of the hypophysis on growth was demonstrated by studies in which intraperitoneal administration of a saline extract of anterior pituitary lobes was found to increase body weight in rats [3]. In a classic series of experiments in 1930, the necessity for the hypophysis for normal growth was conclusively demonstrated [4]. Ablation of the hypophysis resulted in the cessation of growth, which was restored by anterior pituitary lobe transplants. When injected intraperitoneally, a saline suspension of anterior lobes stimulated growth in hypophysectomized rats but had no effect on the atrophied reproductive organs.

The indications for and efficacy of exogenous growth hormone (GH) treatment in children with GH deficiency are reviewed here. The diagnostic approach to the child with short stature and the diagnosis of GH deficiency are discussed separately. (See "Causes of short stature" and "Diagnostic approach to children and adolescents with short stature" and "Diagnosis of growth hormone deficiency in children".)

GH therapy is also prescribed for several other specific indications in children and adolescents, including idiopathic short stature, and short stature associated with small for gestational age, chronic kidney disease, Turner syndrome, Prader-Willi syndrome, mutations in the SHOX gene, and Noonan syndrome. These uses are discussed in separate topic reviews:

(See "Growth hormone treatment for idiopathic short stature".)


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Literature review current through: May 2017. | This topic last updated: Apr 06, 2017.
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