Catch-up growth in patients with congenital or acquired growth hormone deficiency after GH replacement: Clinical features and hypothalamic-pituitary imaging
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2012
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SPRINGER NEW YORK
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Carvalho, L. R.; Arnhold, I. J. P.; Mendonca, B. B.; Costalonga, E. F.; Otto, A. P.; Da Costa Leite, C.; Lucato, L. T.; Peruchi, M. M.. Catch-up growth in patients with congenital or acquired growth hormone deficiency after GH replacement: Clinical features and hypothalamic-pituitary imaging. In: . HANDBOOK OF GROWTH AND GROWTH MONITORING IN HEALTH AND DISEASE: SPRINGER NEW YORK, 2012. p.963-985.
Resumo
Hypothalamic and pituitary disorders usually impair statural growth. These disorders may be either congenital or acquired with differences in clinical presentation. Growth failure is mainly related to growth hormone deficiency (GHD) that can be accompanied by other pituitary hormone deficiencies. The onset of clinical features may be insidious and unnoticed for years or decades. Therefore, it is important to periodically assess auxologic data such as height, growth velocity, bone maturation and evaluate hormonal levels related to hypothalamic-pituitary axis in these patients. Magnetic resonance imaging (MRI) greatly improved the study of central nervous system (CNS) disorders including the hypothalamic-pituitary region. Currently, it is an essential tool in the definition of the etiology of GHD. It can detect tumors that may require surgical intervention, and also provide insights into other causes of GHD. Catch up growth of congenital disorders is essentially dependent on hormone replacement. Even with an initial diagnosis of IGHD, attention should be given to the risk of the development of multiple pituitary hormone deficiencies. In addition to the hormonal deficiencies due to the acquired disorder themselves; their treatment (surgery, irradiation, chemotherapy) often leads to combined pituitary deficits. Growth responsiveness to rhGH has safety aspects of treatment which deserve additional discussion. © Springer Science+Business Media, LLC 2012. All rights reserved.
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Referências
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