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The child body has a dynamic structure that shows continuous growth and development. Growth is the most important indicator that a child is healthy. American Hospital Pediatric Endocrinology Specialist Nihal Memioğlu “The normal growth and development process is affected by genetic, nutritional, hormonal and psychosocial factors. In addition, all organ systems in the body should work in a healthy way. ”
American Hospital Pediatric Endocrinology Specialist Nihal Memioğlu talks about what is curious about growth:
Growth retardation is one of the most important findings in hormone deficiencies. Thyroid and sex hormones, especially growth hormone (GH) secreted from the pituitary gland, regulate the growth.
Growth hormone does not show a regular release, it occasionally makes secretion attacks. Oscillatory attacks are frequent especially during night sleep. Its main effects are; Increases blood sugar, increases fat breakdown in the body, reduces cholesterol and triglycerides, stimulates protein synthesis and cell production. The latter effect is most pronounced on bone and cartilage tissue. BH and some growth factors produced in the body by this effect cause the growth of cartilage cells in the growth plate by dividing and proliferating at the bone ends.
In the absence of growth hormone, the child's height remains below the standard for his or her age group. This retardation becomes apparent especially after the age of 2 years. Body parts are proportional to each other in the patient's belly, fat is seen. Weight is higher than the neck, bone maturation (bone age) is behind. In severe and early-onset cases, the forehead is prominent, the nasal root is flattened (stone doll face), the skin and hair are thin, the sound is high-pitched. In childhood and early childhood, low starvation sugar may develop.
A deficiency of GH seen in approximately 4000 live births can be caused by many reasons. Developmental disorders of the pituitary gland, deficiency or structure of hormone production due to gene disorder, brain diseases, tumors, surgical applications and head traumas, radiation applied to the head, disorders of the hormone sensing system (receptor) of the tissues are the main causes. In addition, malnutrition, lovelessness and transient lack of GH may be seen during some medications.
The reasons that may lead to this need to be investigated in children whose height is below the standard, the bone age is back, one-year extension is less than expected in that age group (if the annual elongation from 4 years is less than 4cm, there is insufficient elongation). It should be shown that there are no other reasons for short stature in such patients. Furthermore, if the child's height is behind the family potential, further research is needed. In the next stage, it is necessary to assess whether there is a deficiency of GH. Since there is no regular release of growth hormone, the level of hormone in the blood taken at any hour can be misleading. Therefore, warning tests should be performed to determine the actual hormone level under the supervision of pediatric endocrinologist. If insufficient GH increase is detected in two different stimulation tests, it is diagnosed as “growth hormone deficiency..
Nowadays, treatment of GH deficiency can be performed successfully. The treatment uses human BH produced by DNA technology. The hormone is administered in the form of subcutaneous injections with special pencils. Injections are performed before bedtime to ensure compliance with normal physiology. Treatment should continue until the growth plates (epiphysis) are closed. It is absolutely necessary to stay under the control of endocrinologist in terms of dose, contribution to growth and side effects. The side effects of growth hormone therapy, which is in the form of the replacement of the missing hormone, are minimal and controlled by laboratory tests in 3-month intervals.
Growth hormone drugs are imported drugs, drugs belonging to five firms in Turkey is still in active use. It is a high cost treatment. Most of the health insurances in our country cover the treatment expenses.