Growth Hormone Secretion in Children of Short Stature
In children of short stature, usually defined as height at 2 standard deviations or more below the normal mean for age, it is generally accepted that growth hormone (GH) function should be assessed. It is also necessary, before performing any investigation, to analyse the clinical features, the familial and social background, the growth and developmental pattern of the child. In fact there is a large range of clinical features extending from the very typical picture of pituitary dwarfism to that of constitutional short stature; and it is our impression that, in a fair number of cases, it remains difficult to predict an impairment of G?? secretion. Furthermore, extensive evaluation of GH function has led to the description of more complex causes of growth retardation such as transitory GH deficiency, resistance to circulating GH with lack of somatomedin generation, and biologically inactive growth hormone. Classification of patients in some of these categories is also necessary to establish treatment strategy, in view of the growing demand for and perhaps better availability of human growth hormone. Some of these aspects are discussed in the following, with particular emphasis on transitory and partial GH deficiency.
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