Management

Grow Taller 4 Idiots

How to Grow Taller

Get Instant Access

Growth Hormone Deficiency

If growth failure is due to documented growth hormone (GH) deficiency, then growth hormone is appropriate treatment. Growth failure can occur due to the systemic effects of cancer or cancer treatment and not necessarily due to GH deficiency, in which case GH should not be administered. The following are clinical considerations in the use of GH:

• It does not increase the incidence, but does worsen the degree of scoliosis.

• It may cause benign intracranial hypertension (pseudotumor cerebri), which resolves with medical management (i.e., acetazolamide and dexamethasone) and discontinuation of GH therapy.

• Children with prior neoplastic disease may develop a second cancer following GH therapy, but the incidence does not appear to be greater than expected.

GH treatment is useful for children with a history of previous cancer who have GH deficiency. They should be cancer free for 1-2 years following cessation of chemotherapy. Patients should understand the benefits of GH therapy in terms of

Table 27-9. Anterior Pituitary Hormones, Their Physiologic Functions, and Their Hypothalamic Regulatory Factors

Pituitary hormone

Functions of pituitary hormone

Hypothalamic regulatory factor

Growth hormone (GH)

Prolactin (PRL)

Gonadotropins Luteinizing hormone (LH)

Follicle-stimulating hormone (FSH)

Thyroid-stimulating hormone (TSH) Adrenocorticotropin (ACTH)

Bone and soft-tissue growth through insulinlike growth hormones (ISF-1) Induction of lactation and interruption of ovulation and menstruation during postpartum period

In males, LH stimulates Leydig cells to produce testosterone; in females, LH is responsible for normal steroidogenesis and ovulation In males, FSH stimulates spermatogenesis; in females, FSH is responsible for normal steroidogenesis and ovulation TSH regulates thyroid hormone production for thyroid gland ACTH regulates adrenal steroidogenesis

Growth-hormone-releasing hormones (GHRH) (+) Somatostatin (-) Dopamine (-)

Gonadotropin-releasing hormone (GnRH) (+)

Gonadotropin-releasing hormone (GnRH) (+)

Thyrotropin-releasing hormone (+) Corticotropin-relasing Hormone (+)

Notes. (+), stimulating effect; (-), inhibitory effect.

From Sklar CA. Neuroendocrine complications of cancer therapy. In: Schwartz CL, Hobbie WL, Constine LS, Ruccione KS, editors. Survivors of childhood cancer: assessment and management. St. Louis: Mosby, 1994:97-110, with permission.

Table 27-10. Summary of Neuroendocrine Complications, Their Clinical Manifestations, Standard Fractionated Radiation Dose Limits to Brain

Responsible for Damage, Diagnostic Studies, and Treatment

Table 27-10. Summary of Neuroendocrine Complications, Their Clinical Manifestations, Standard Fractionated Radiation Dose Limits to Brain

Responsible for Damage, Diagnostic Studies, and Treatment

Was this article helpful?

0 0
10 Ways To Fight Off Cancer

10 Ways To Fight Off Cancer

Learning About 10 Ways Fight Off Cancer Can Have Amazing Benefits For Your Life The Best Tips On How To Keep This Killer At Bay Discovering that you or a loved one has cancer can be utterly terrifying. All the same, once you comprehend the causes of cancer and learn how to reverse those causes, you or your loved one may have more than a fighting chance of beating out cancer.

Get My Free Ebook


Post a comment