from 5 cm/y to 11 cm/y. How does GH stimulate growth in children? What other hormone deficiencies are sug- gested by the patient's history and physical examination? What other hormone replacements is this patient likely to require?

Biology: The Unity and Diversity of Life (MindTap Course List)
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Chapter34: Endocrine Control
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37
Roger K. Long, MD, & Hakan Cakmak, MD
Hypothalamic & Pituitary
Hormones
CASE STUDY
A 4-year-old boy (height 90 cm, -3 standard deviations
[SD]; weight 14.5 kg, approximately 15th percentile)
presents with short stature. Review of the past history
and growth chart demonstrates normal birth weight and
birth length, but a progressive decrease in height per-
centiles relative to age-matched normal ranges starting
Laboratory evaluations demonstrate growth hormone
(GH) deficiency and a delayed bone age of 18 months.
The patient is started on replacement with recombinant
human GH at a dose of 40 mcg/kg per day subcutaneously.
After 1 year of treatment, his height velocity has increased
from 5 cm/y to 11 cm/y. How does GH stimulate growth
in children? What other hormone deficiencies are sug-
at 6 months of age, and orthostasis with febrile illnesses.
Physical examination demonstrates short stature and
mild generalized obesity. Genital examination reveals
descended but small testes and a phallic length of -2 SD.
gested by the patient's history and physical examination?
What other hormone replacements is this patient likely
to require?
The control of metabolism, growth, and reproduction is me
(ed by a combination of neural and endocrine systems located
a the hypothalamus and pituitary gland. The pituitary weighs
pout 0.6 g and rests at the base of the brain in the bony sella
TCica near the optic chiasm and the cavernous sinuses. The
Tuitary consists of an anterior lobe (adenohypophysis) and a
sterior lobe (neurohypophysis) (Figure 37–1). It is connected
The overlying hypothalamus by a stalk of neurosecretory fibers
and blood vessels, including a portal venous system that drains
the hypothalamus and perfuses the anterior pituitary. The portal
venous system carries small regulatory hormones (Figure 37–1,
Table 37–1) from the hypothalamus to the anterior pituitary.
The posterior lobe hormones are synthesized in the hypothala-
mus and transported via the neurosecretory fibers in the stalk of
the pituitary to the posterior lobe; from there they are released
into the circulation.
667
Transcribed Image Text:37 Roger K. Long, MD, & Hakan Cakmak, MD Hypothalamic & Pituitary Hormones CASE STUDY A 4-year-old boy (height 90 cm, -3 standard deviations [SD]; weight 14.5 kg, approximately 15th percentile) presents with short stature. Review of the past history and growth chart demonstrates normal birth weight and birth length, but a progressive decrease in height per- centiles relative to age-matched normal ranges starting Laboratory evaluations demonstrate growth hormone (GH) deficiency and a delayed bone age of 18 months. The patient is started on replacement with recombinant human GH at a dose of 40 mcg/kg per day subcutaneously. After 1 year of treatment, his height velocity has increased from 5 cm/y to 11 cm/y. How does GH stimulate growth in children? What other hormone deficiencies are sug- at 6 months of age, and orthostasis with febrile illnesses. Physical examination demonstrates short stature and mild generalized obesity. Genital examination reveals descended but small testes and a phallic length of -2 SD. gested by the patient's history and physical examination? What other hormone replacements is this patient likely to require? The control of metabolism, growth, and reproduction is me (ed by a combination of neural and endocrine systems located a the hypothalamus and pituitary gland. The pituitary weighs pout 0.6 g and rests at the base of the brain in the bony sella TCica near the optic chiasm and the cavernous sinuses. The Tuitary consists of an anterior lobe (adenohypophysis) and a sterior lobe (neurohypophysis) (Figure 37–1). It is connected The overlying hypothalamus by a stalk of neurosecretory fibers and blood vessels, including a portal venous system that drains the hypothalamus and perfuses the anterior pituitary. The portal venous system carries small regulatory hormones (Figure 37–1, Table 37–1) from the hypothalamus to the anterior pituitary. The posterior lobe hormones are synthesized in the hypothala- mus and transported via the neurosecretory fibers in the stalk of the pituitary to the posterior lobe; from there they are released into the circulation. 667
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