Clinical, Anthropometric and Dynamic Clonidine Stimulated Growth Hormone Study in Short Stature Children

Abstract

Background: Growth hormone is the important hormone controlling growth from birth to adolescence. Children with growth hormone deficiency usually present with severe short stature and correct diagnosis by provocative GH test is essential so as to treat such children with costly GH available now. Aim: To study the clinical profile, Anthropometric measurements, Growth Hormone dynamics, Thyroid functions test in short stature children. Methods: Children with height 2 standard deviation below the mean for the age (WHO Growth Charts up to 5 years and Agarwal DK et al growth reference after 5 years) and Children referred to short stature as the primary complaint were included in the study. Anthropometric measurements, clinical examination, dynamic clonidine provocative GH tests were done. Results: Out of 30 short children, 25 children (83%) were identified as having growth hormone deficiency as evidenced by subnormal growth hormone response (peak GH below 10ng/ml). 4 children (13%) were identified as having GH insensitivity (or) Laron's dwarfism in the form of supra-physiological level of serum GH. One child showed normal GH response. Among 25 children who showed GHD 3 of them also showed clinical hypothyroidism as evidenced by the rise of serum TSH level above 5.5 units/ml. Conclusion: Growth hormone abnormality was found to be the most common cause for pathological short stature (96%) when chronic systemic disorders were excluded.