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Decreased growth hormone is trouble
a simple case introducing clincial presentation and calling for a differential diagnosis. To get students thinking.
Congenital GH deficiency can be:
Acquired GH deficiency:
GH is important for chondrocyte proliferation and IGF-1 release. GH has little impact on fetal growth, as maternal and placental factors are more important.
IGF-1 acts on the liver and long bones.
Impaired QoL
high-pitched voice
Short, chubby infants
delayed puberty
hypoglycemia
GH stimulation testing if strong indication
Other causes of short stature should be strongly considered, as true GH deficiency is quite rare.
GH replacement if GH is proven to be deficient, if epiphyses are unfused, and...
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