Managing Growth Hormone Deficiency Across the Continuum of Care - Episode 1
Unraveling Growth Hormone Deficiency — Etiology and Prevalence
Experts compare pediatric vs adult growth hormone deficiency—causes, testing, MRI use, and why retesting matters during transition to adult care.
Welcome back to another HCP Live Peer Exchange series. In this episode titled “Unraveling Growth Hormone Deficiency — Etiology and Prevalence,” moderator Dr. Joshua Yang discusses growth hormone deficiency with Dr. Craig Alter, Dr. Jose Garcia, and Dr. Nidhi Agrawal.
In this opening episode, the panel introduces the HCP Live Peer Exchange series focused on Managing Growth Hormone Deficiency Across the Continuum of Care. Dr. Joshua Yang sets the stage by outlining the program’s scope, which encompasses diagnosis, treatment decision-making, transition of care, and real-world clinical challenges across both pediatric and adult populations.
Dr. Yang begins by discussing the prevalence of GHD in children. Worldwide, GHD affects approximately 1 in 4,000 to 1 in 10,000 children, though in the U.S. the rate is closer to 1 in 3,000 — likely because American clinicians tend to treat milder and moderate cases, and use a higher GH peak cutoff of 10 ng/mL versus the European standard of 7 ng/mL.
Dr. Garcia adds that adult GHD is estimated at 1 in 50,000 to 1 in 100,000 individuals, though emerging data suggests higher prevalence — with up to 10–15% of patients with prior head trauma also harboring GHD.
The panel then explores etiologies. In children, causes are often congenital (midline defects, pituitary genetic mutations) or idiopathic. Dr. Alter stresses that the primary clinical priority is always accurate diagnosis before treatment — illustrated by a case of a craniopharyngioma initially presenting only as delayed puberty. For adults, structural causes dominate: pituitary adenomas, craniopharyngiomas, radiation, surgery, stroke, or trauma.
The episode closes with a discussion of idiopathic pediatric GHD patients — often mild or moderate cases — and the question of whether they carry GHD into adulthood. The consensus is that retesting is essential, and that IGF-1 alone is not reliable enough to confirm or exclude adult GHD.
In the next episode, “Recognizing Growth Hormone Deficiency — Symptoms, Presentation, and Quality of Life,” the panel explores how GHD presents at different ages in children and the long-term consequences of undiagnosed or undertreated GHD.
