Catch-Up Growth in Patients with Congenital or Acquired Growth Hormone Deficiency After GH Replacement: Clinical Features and Hypothalamic–Pituitary Imaging

  • Luciani R. Carvalho
  • Ivo J.P. Arnhold
  • Berenice Bilharinho Mendonca
  • Everlayny Fiorot Costalonga
  • Aline Pedrosa Otto
  • Claudia da Costa Leite
  • Leandro Tavares Lucato
  • Mirella Maccarini Peruchi


Hypothalamic and pituitary disorders usually impair statural growth. These disorders may be either congenital or acquired with differences in clinical presentation. Growth failure is mainly related to growth hormone deficiency (GHD) that can be accompanied by other pituitary hormone deficiencies. The onset of clinical features may be insidious and unnoticed for years or decades. Therefore, it is important to periodically assess auxologic data such as height, growth velocity, bone maturation and evaluate hormonal levels related to hypothalamic–pituitary axis in these patients. Magnetic resonance imaging (MRI) greatly improved the study of central nervous system (CNS) disorders including the hypothalamic–pituitary region. Currently, it is an essential tool in the definition of the etiology of GHD. It can detect tumors that may require surgical intervention, and also provide insights into other causes of GHD. Catch up growth of congenital disorders is essentially dependent on hormone replacement. Even with an initial diagnosis of IGHD, attention should be given to the risk of the development of multiple pituitary hormone deficiencies. In addition to the hormonal deficiencies due to the acquired disorder themselves; their treatment (surgery, irradiation, chemotherapy) often leads to combined pituitary deficits. Growth responsiveness to rhGH has safety aspects of treatment which deserve additional discussion.


Diabetes Insipidus Pituitary Stalk Central Precocious Puberty rhGH Treatment Isolate Growth Hormone Deficiency 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



Adrenocortical-stimulating hormone




Body mass index


Central nervous system


Central precocious puberty


Computed tomography


Diabetes insipidus


Ectopic posterior pituitary


Growth hormone 1 gene


Growth hormone-releasing hormone receptor gene


GLI-KRUPPEL family member gene 2


Growth hormone


Growth hormone binding protein


Growth hormone deficiency


growth hormone-releasing hormone


Homeobox embryonic stem cell 1 gene


Human chorionic gonadotropin


Insulin-like growth factor 1


Insulin-like growth factor binding protein 3


Isolated growth hormone deficiency


Langerhans cell histiocytosis


Lim Homeobox 4 gene


Multiple pituitary hormone deficiency


Magnetic resonance imaging


Orthodenticle, drosophila, homolog of, 2 gene


Pou Domain, Class1, Transcription factor 1, POU1F1 gene


Prophet of pit 1 gene


Recombinant human growth hormone


Standard deviation score


Septo-optic dysplasia


SRY-BOX 2 gene


SRY-BOX 3 gene




Traumatic brain injury


Thyroid-stimulating hormone


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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Luciani R. Carvalho
    • 1
  • Ivo J.P. Arnhold
    • 1
  • Berenice Bilharinho Mendonca
    • 1
  • Everlayny Fiorot Costalonga
    • 1
  • Aline Pedrosa Otto
    • 1
  • Claudia da Costa Leite
    • 2
  • Leandro Tavares Lucato
    • 2
  • Mirella Maccarini Peruchi
    • 2
  1. 1.Division of EndocrinologyHospital das Clinicas, University of São Paulo Medical SchoolSão PauloBrazil
  2. 2.Division of RadiologyHospital das Clinicas, University of São Paulo Medical SchoolSão PauloBrazil

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