Pediatric Growth Hormone Deficiency (PGHD) may happen when the body is unable to produce enough growth hormone (GH) or use it effectively. GH produced in the body plays a critical role in helping young bodies grow and develop, including improving muscle metabolism, growing bones, and breaking down fats. When levels of GH are too low, there may be an impact on growth and many functions of the body.

PGHD may be present at birth or develop at any time during childhood or adolescence. There are many possible causes of PGHD. Damage to, or an abnormality in, the pituitary gland or the hypothalamus (the part of your brain that controls the pituitary gland) are among them.

If PGHD is diagnosed, the doctor may prescribe GH therapy. The form of GH used as a medication is the same protein that is made naturally in the body.

Nutropin AQ^® (somatropin) therapy

Doctors prescribe Nutropin therapy for children and teenagers who are short or growing slowly because they do not make enough growth hormone on their own.

For appropriate children and teenagers with PGHD, treatment means taking regular GH injections under the ongoing supervision of a healthcare professional (HCP). Treatment continues until the HCP determines that GH therapy should end.

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For pediatric GHD patients who are still GH deficient as adults, a commitment to ongoing therapy is necessary even after finishing puberty and reaching full height because growth hormone helps the body maintain a healthy balance between lean mass and body fat.

When to evolve your treatment goals and treatment team from a pedatric to adult focus:

The American College of Endocrinology recommends when your child is between the ages of 15-18, an adult endocrinologist can work with your child’s pediatrician to determine the level of continued care needed. Tests to determine growth hormone levels and other measurements will be done. If it is determined your child can benefit from ongoing therapy, an adult endocrinologist will help shift treatment goals. Adult treatment goals include improvements in:

• Body composition
• Cholesterol profile
• Bone mineral density

Remember – Treatment goals are not just about height!

Reference: AACE 2019 Guidelines for Management of Growth Hormone Deficiency in Adults and Patients Transitioning from Pediatric to Adult Care.
Available at:
https://www.ncbi.nlm.nih.gov/pubmed/31760824
https://journals.aace.com/doi/pdf/10.4158/GL-2019-0405

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Adult-onset Adult Growth Hormone Deficiency (AGHD) may occur when an adult’s pituitary gland does not work effectively. Adult-onset AGHD may have been caused by damage to the pituitary gland or hypothalamus, which may impact its ability to make enough GH.

This damage is most commonly caused by a tumor in and around the pituitary. Such a tumor may compress the gland, or the damage may occur when the tumor is removed through neurosurgery. The pituitary gland may also be damaged by infection, blood vessel disease, severe head injury, or radiation treatment. Damage to the pituitary gland may affect the production of one or more pituitary hormones, including GH.

Nutropin AQ^® (somatropin) therapy

Doctors prescribe Nutropin therapy for adults who have growth hormone deficiency that began either in:

• Adulthood as a result of pituitary disease, diseases of the hypothalamus, surgery, radiation therapy, or trauma; or
• Childhood. Patients treated for growth hormone deficiency in childhood, whose bones have stopped growing, should be reevaluated to see if they need to continue with growth hormone therapy
  

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When a child or a teenager is growing poorly, but his or her body appears to be making normal amounts of growth hormone (GH), he or she is said to have Idiopathic Short Stature (ISS). “Idiopathic” means the cause is unknown; “short stature” means the child or teenager is markedly shorter than others of his or her age and gender.

Nutropin AQ^® (somatropin) therapy

Doctors prescribe Nutropin therapy for children and teenagers who are short or growing slowly because they:

• Have idiopathic short stature, which means they are shorter than 98.8% of other children of the same age and sex; are growing at a rate not likely to allow them to reach normal adult height; and no other cause of short stature can be found

Taking GH therapy means taking regular injections of growth hormone (such as Nutropin) until the growing ends of your bones fuse, or as your doctor recommends.

Turner syndrome (TS) is a genetic condition that affects about 1 in every 2,500 female live births. TS occurs when one of a girl’s two X chromosomes is absent or incomplete. The most common feature of TS is short stature, which affects nearly 100% of girls with TS. That’s because the missing or incomplete X chromosome contains a gene that helps girls grow to a normal height.

From birth through their teen years, girls with TS grow more slowly than unaffected children. In fact, the average adult height of women with TS is about 4’8”, while unaffected women average about 5’4”.

Nutropin AQ^® (somatropin) therapy

Doctors prescribe Nutropin therapy for children and teenagers who are short or growing slowly because they have Turner syndrome.

For most girls with TS, one part of treatment means taking regular GH injections under the ongoing supervision of a healthcare professional (HCP). Treatment continues until growth stops or the HCP determines that GH therapy should end.

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Chronic Kidney Disease (CKD) is a loss of kidney function over a period of months or years. Most young people with CKD produce as much growth hormone (GH)
as anyone their age. The problem is that their kidneys aren’t filtering waste from their blood as well as they should. Because so much waste is trapped in their blood, their bodies aren’t able to use GH effectively. Because of CKD, GH and insulin-like growth factor (IGF) can’t connect properly. GH signals IGF to travel to muscles, organs, and bones and tells the bones to grow. It also helps improve muscle metabolism. When GH and IGF aren’t working together, it means:

• Growth may be slowed or stopped
• Muscles, organs, and bones may not get the GH they need to develop properly

Nutropin AQ^® (somatropin) therapy

Doctors prescribe Nutropin therapy for children and teenagers with growth failure associated with CKD up to the time of kidney transplant. Nutropin is the only growth hormone with the FDA approved indication of treatment of children with growth failure who have CKD up to the time of renal transplantation.

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