Endocrinology

Facilitating therapy for children
EMD Serono, Canada, offers state-of-the-art recombinant technology for the treatment of endocrine disorders in children and adults. The ease of administration of therapy in these chronic conditions has a considerable impact on patients’ quality of life. Our ongoing pursuit to further facilitate therapy, especially for children, has culminated in the launch of an award-winning injection system.

More about Growth Hormone Deficiency

Growth hormone (GH) plays a central role in the growth process and maturation from child to adulthood. It also regulates a number of metabolic and physiological processes throughout life. GH deficiency occurs when the pituitary gland in the brain is unable to produce or release sufficient amounts of GH.
Growth Hormone Deficiency (GHD) can be grouped into 3 types:
  • Congenital: caused by a problem with the pituitary gland or hypothalamus during fetal development
  • Acquired: caused by damage to the pituitary gland or hypothalamus from tumors, severe head injury or infections such as meningitis or encephalitis
  • Idiopathic: unknown cause

Childhood GHD

In unaffected children, GH works throughout the body to stimulate growth. Not having enough of this hormone affects the body’s basic supplies for growth. This lack has a number of consequences:
  • Inability to make enough new proteins to build muscles, resulting in weakness and impact on the ability to exercise
  • Failure to stimulate production of other hormones, such as insulin-like growth factor (IGF-1), which is especially important in stimulating bone growth
  • Failure to signal other parts of the body involved in growth
  • In children, lack of GH results in short stature, delayed maturation and inability to grow strong bones. In addition, the face may remain childish and the child may accumulate increased fat particularly around the stomach area.
The earlier a treatable growth problem is detected, the better the child’s chance of achieving a normal height throughout childhood and realizing his or her full growth potential. In a society that places great emphasis on height, children who are short for their age sometimes have problems because playmates and teachers treat them as though they are younger rather than just smaller.
Other related growth disorders include:
  • Small for Gestational Age (SGA): Babies born small for gestational age (SGA) as compared with other babies who had the same amount of time in the womb generally grow faster in the first months of life. Thanks to this ‘catch up’ growth, they often reach the same size as normal babies by about 2 years of age. If this is not the case, extra GH can help SGA babies achieve normal adult height.
  • Turner Syndrome (TS): Named after the endocrinologist Dr Henry Turner who first described the condition in 1938, Turner Syndrome is caused by a genetic defect that occurs only in girls. Most girls are born with two female X chromosomes; in girls born with TS, one of the two X chromosomes is missing, incomplete or damaged. TS can cause growth disorders and short stature. Early GH therapy has been shown to increase the rate of gain in height in girls with TS and may increase final adult height.
  • Chronic renal failure (CRF): Also known as chronic kidney disease, CRF describes kidney malfunction that develops gradually over time (at least three months). As CRF progresses, the kidneys become less able to remove waste and extra water from the body. Children with CRF often have poor growth and can be treated by GH.

Adult Growth Hormone Deficiency

Growth deficiencies do not just affect children – they can be a significant problem for adults, too. Until recently, the effects of GHD in adults were unknown. Adult GHD is now recognized as a specific clinical syndrome with numerous physiological consequences including effects on:
  • Body composition, including central obesity
  • Cholesterol production in the blood
  • Muscle strength
  • Bone composition
  • Exercise capacity and energy
  • Cardiovascular risk
  • Psychological well-being
GHD in adults can result from a pituitary or peri-pituitary tumor or as a direct result of surgery or radiation used to manage these conditions. Less commonly, GHD in adults arises from a deficiency acquired in childhood.
In adults, the signs of GHD are more subtle than in children. These may include both psychological symptoms such as depression, anxiety, poor memory and social isolation; along with physiological problems including weakness, poor vitality, easy fatigue and weight gain.

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Facilitating therapy for children

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