GROUP NO #06

• Alyan Khan ( 70130548 )

• Iqra fayyaz ( 70130757 )
• Amna Noor ( 70132329 )
• Riffat shoukat ( 70131160 )
• Tayyab Ijlal ( 70132109 )
• Shad Muhammad ( 70132702)
• Izaz ahmad ( 70130542 )
Presented to : Sir saifullah
Presented by : Group #06
Subject : Pathophysiology
Degree : BS Nursing
Topic : Disorder of Growth Hormone

Lahore School of Nursing

 LEARNING OBJECTIVES
• At the end of this presentation student will be able to learn :
• Define Growth Hormone
• Structure and Function of Growth Hormone
• Disorder of Growth Hormone
1. pan hypopituitarism
2. Dwarfism
3. Gigantism
4. Acromegaly
5. Turner syndrome
 GROWTH HORMONE:

Also known as somatotropin Hormone.

Produce by the anterior Pituitary gland in the brain.

Anterior pituitary is under the hypothalamus

regulation for the secretion of growth hormone.
STRUCTURE OF GH:

Single
Polypeptide
chain Composed of
191 Amino Acid Molecular
weight 21500
Daltons Two disulfide
Bridge
 Hypothalamus

GHRH GHIH

Anterior pituitary

Growth Hormone
Function of Growth hormone:

Stimulation of Growth:

GH is most renowned for its role in promoting growth

during childhood and adolescence. It stimulates the growth
of bones, cartilage, and tissues by increasing the number
and size of cells.

Regulation of Height: Growth hormone is instrumental in

determining an individual's final height. During the growth
spurts of adolescence, GH is at its peak, and it contributes
to the elongation of long bones.
Conti…
Muscle Growth and Strength:

GH enhances muscle growth and increases muscle strength. It

does so by promoting the synthesis of proteins and the
development of lean muscle mass.

Fat Metabolism:

Growth hormone promotes the breakdown of fats (lipolysis)

and their conversion into energy. This helps in reducing body
fat and maintaining a healthy body composition.
Disorder of Growth Hormone:

Panhypopituitarism

Dwarfism

Gigantism

Acromegaly
 Panhypopituitarism:
Meaning:
“Pan” mean “All”
“Hypo” mean “Deficient”
“Pituitar” mean “Pituitary”
“Ism” mean “Condition”
Definition:
Decreased Secretion of all anterior pituitary hormones.
Conti…
Causes:
( Mainly Tumor )
• Craniopharngioma
• Chromophobe tumor
• Thrombosis of pituitary blood vessels
Effects:
• Hypothyroidism Lethargic
• Glucocorticoids Weight gain
• Growth hormone Fat utilisation,Protein anabolism
• Gonadotropics Loss of sexual function
Conti…
Investigation:
Diagnosis typically involves blood tests to measure hormone
levels such as,
imaging studies (MRI or CT scans) to assess the pituitary gland,
and sometimes stimulation tests to evaluate hormone responses.
Treatment:
Treatment may involve hormone replacement therapy to address
the specific deficiencies identified in the individual.
 Dwarfism:

Definition:
Dwarfism is a disorder characterised by shorter than normal
skeletal growth.
 Defined as an adult height of 4 feet 10 inches(147cm)
 Average adult height among people with dwarfism 4 feet
122cm.

Cause: panhypopituitarism in childhood

Conti…
Conti…
Effect:
• Development of body part decreased
( But in appropriate proportion to one another)
• Weight gain Glucocorticoid )
• Lethargy Thyroid hormone )
• Sexual function lost LH,FSH )
( In 1/3rd dwarf: only Growth hormone decreased
:- They do mature sexually
Conti…
Investigation:

 Medical history
 Physical examination
 Growth assessment
( Monitoring individual growth patterns and growth
velocity over time is essential )
 Imaging X-rays & Bone age assessment
( Evaluate the development of bones and growth plaltes in
children )
 Laboratory tests
( measure hormone level,including GH ( IGF-1 )
Conti…
Lorain Dwarfism:
 Also known as Laron Syndrome.
 Laron type dwarfism is a rare genetic disorder that results in
dwarfism.
 It is caused by mutation in the growth hormone receptor gene
which leads to an inability to respond to growth hormone.
 Have short stature but also have other health issues.
 Gigantism:
Definition:
It is defined as abnormally large growth due to an excess
growth hormone during childhood before growth plate have
close.
 People with this condition can grow as tall as 7ft-8ft.
Conti…
Etiological Factor:
• Pituitary tumor/Adenoma
• Tumor/cancer of lung,pancrease,Adrenal gland
Clinical Manifestation:
 Extremely tall stature
 Large hand and feet
 Prominent forehead and jaw
 Persistent headaches
 Irregular menstrual period in girl
 Visual changes
 Deafness,Weakness
Conti…
Conti…
Investigation:
 Medical History
 Physical Examination
 Insulin IGF-1
 CT scan
 MRI
 Conti…
Treatment :
1. Medical Management:
Medications:
 Somatostatin analogs like octreotide and lanreotide can help
regulate growth hormone levels
 Dopamine agonists like cabergoline may be used in some
cases to control hormone production.
 Growth hormone receptor antagonists like pegvisomant can
block the action of excess growth hormone.
Conti…
Surgical Management:
 Transsphenoidal surgery is often performed to remove the
tumor (usually a pituitary adenoma) causing the
overproduction of growth hormone.
 In some cases, additional surgery or radiation therapy may be
necessary if the tumor is not fully removed or if it regrows.
 Acromegaly:

Definition:
Acromegaly is a rare but serious medical condition that
happens when you have too much growth hormone in your body.
Acromegaly affects your body’s bones and tissues and causes
them to grow in irregular ways.
 Acromegaly can develop at any age after puberty, but
healthcare providers most often diagnose it during the fourth
and fifth decades of life (middle age).
 Acromegaly is rare. Approximately 3 to 14 of every 100,000
people have been diagnosed with acromegaly.
Conti…
Clinical Manifestation:
 Adults with acromegaly may experience the following
symptoms:
 Enlarged hands or feet.
 Changes in your face shape, including a more prominent jaw
and/or forehead.
 Increase in size of your lips, nose and/or tongue.
 Excessive sweating or oily skin.
 Deepening of your voice.
 Conti…
 Other symptoms include:
 Headaches.
 Joint pain.Vision changes.
 Increase in the number of skin tags.
 Numbness in your hands.
 Sleep apnea.
 Carpal tunnel syndrome or spinal cord issues.
Conti…
Investigation:
 An echocardiogram to check for heart issues.
 Sleep study tests to check for sleep apnea.
 A colonoscopy to assess the health of your colon.
 X-rays or a DEXA (DXA) scan to check bone health.
Conti…
Causes:
The most common cause of acromegaly is a tumor in your
pituitary gland called a pituitary adenoma that causes your
pituitary gland to release excess growth hormone (GH).
Conti…
Treatment:
There are several treatment options for acromegaly.
common treatments for acromegaly are;
 Medication
 Surgery
 Radiation therapy.
 Turner Syndrome(TS):
Definition:
Turner Syndrome is a chromosomal disorder that affects
females. It is characterized by the partial or complete absence of
one X chromosome, leading to a range of physical and
developmental abnormalities.
Conti…
Causes:
The primary cause of Turner Syndrome is the loss of genetic
material from one of the X chromosomes. This can occur due to
random genetic errors during fetal development. It is not
typically inherited.
 Conti…
Investigations:
Diagnosing Turner Syndrome may involve:
 Karyotype analysis to identify the chromosomal abnormality.
 Imaging tests (e.g., ultrasound) to assess heart and kidney
function.
 Hormone tests to evaluate growth hormone levels.
Conti…
Clinical Manifestation:
 The most common features of Turner Syndrome include:
 Short stature
 Lack of proper pubertal development Webbed neck
 Low-set ears
 Swelling of hands and feet
 Heart and kidney abnormalities
 Learning difficulties
Conti…
Treatment:
Treatment for Turner Syndrome often focuses on managing the
associated symptoms and promoting normal growth and
development. This can include:
 Growth hormone therapy to increase height during childhood
and adolescence.
 Hormone replacement therapy (HRT) to induce puberty and
provide estrogen replacement.
 Monitoring and treatment of any heart or kidney abnormalities.
 Educational and psychological support for learning difficulties
and social challenges.
 Summary:

• Growth Hormone:
Also known as somatotropin hormone.
Hypothalamus Ant.Pituitary gland Growth Hormone
Structure: Single polypeptide chain
( 191 AA ) (Two Dislufide bridge )
Disorder:
Gigantism ( Excess GH before puberty )
Dwarfism ( Deficiency before puberty )
Acromegaly ( Excess GH after puberty )