5. The Management of Growth Disorders

Summary

All endocrine orders affect growth. This chapter describes how to measure growth and how to detect and treat growth disorders. Postnatal growth is characterized by an infancy phase, regulated by nutrition, a childhood phase regulated by growth hormone and thyroxine and puberty growth regulated by sex steroids. Since normal growth is defined by a normal growth rate, regardless of height achieved, an understanding of how such rates vary in the three phases is key to determining further investigation. Since treatment follows diagnosis, nutrition, growth hormone and sex steroids all have parts to play. Growth hormone is also used in other situations which the chapter describes. A new area of clinical practice is the poor growth which follows the treatment of cancer. Tall stature can be a serious long-term problem as short stature is usually a short-term one; it is extremely important to rule out a diagnosis of precocious puberty and thyrotoxicosis, as well as gigantism.