Hi, this is Tom, and in this episode I'm going to be going through growth hormone deficiency,

and you can find notes at zero to finals.com and in the zero to finals pediatrics book,

and you can find flashcards and questions at members.0.0.0.com.

And at the end of the episode, we'll go through some questions so you can test yourself on what you just heard.

So let's jump straight in.

Growth hormone is produced by the anterior pituitary gland.

It plays a central role in the growth of muscles, bones and tissues.

It also has metabolic effects and it stimulates cell regeneration and proliferation. It stimulates

the release of insulin-like growth factor 1, or IGF1, mainly from the liver,

which also plays an important role in growth.

Congenital growth hormone deficiency results from a disruption to the growth hormone

axis at the hypothalamus or pituitary gland.

Congenital growth hormone deficiency can be due to a genetic mutation affecting the

GH1 or growth hormone 1, or the GHRH or growth hormone-releasing hormone receptor genes, or to another condition such as

empty cellar syndrome where the pituitary gland is underdeveloped or damaged. Acquired growth hormone

deficiency is often idiopathic, where there's no clear cause, but it can be secondary to infection,

trauma or surgery affecting the pituitary. Growth hormone deficiency can occur in isolation

or with other pituitary hormone deficiencies. When the pituitary gland does not produce several

pituitary hormones, this is called hypopeturiturism

or multiple pituitary hormone deficiency.

Hypopaturiturism can also cause hypothyroidism

due to inadequate thyroid-stimulating hormone,

...