Growth hormone-related pathology [Neurosurgery Wiki]

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====== Growth hormone-related pathology ======

[[Somatotroph pituitary neuroendocrine tumor]] old term [[Somatotroph adenoma]]

[[Acromegaly]] is characterized by [[GH]] and [[IGF-1]] hypersecretion, and GH and IGF-1 play important roles in regulating body composition and [[glucose]] homeostasis.

===== Growth hormone deficiency =====

see [[Growth hormone deficiency]].

Excessive growth hormone (GH) is usually secreted by [[Somatotroph pituitary neuroendocrine tumor]]s and causes [[gigantism]] in juveniles or [[acromegaly]] in adults. 

The growth hormone test may be used to monitor response to acromegaly treatment.

Different tests are used to diagnose growth problems:

GHRH or GHRH-arginine stimulation (to help diagnose a lack of growth hormone)

Growth hormone stimulation test

IGF-1 levels

Oral glucose tolerance suppression (to help diagnose too much growth hormone)

Normal Results

The normal range for growth hormone levels is typically:

1 - 9 ng/mL (male)

1 - 16 ng/mL (female)

GH is released in pulses. A higher level may be normal if the blood was drawn during a pulse. A lower level may be normal if the blood was drawn around the end of a pulse.

Normal value ranges may vary slightly among different laboratories. Talk to your doctor about the meaning of your specific test results.
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Co-secretion of [[growth hormone]] (GH) and [[prolactin]] (PRL) from a single [[pituitary neuroendocrine tumor]] is common. In fact, up to 25% of patients with [[acromegaly]] may have PRL co-secretion. The prevalence of acromegaly among patients with a newly diagnosed [[prolactinoma]] is unknown. Given the possibility of mixed GH and PRL co-secretion, the current recommendation is to obtain an insulin-like growth factor-1 (IGF-1) in patients with prolactinoma at the initial diagnosis. Long-term follow-up of IGF-1 is not routinely done
((Manuylova E, Calvi LM, Hastings C, Vates GE, Johnson MD, Cave WT Jr, Shafiq I.
Late presentation of acromegaly in medically controlled prolactinoma patients.
Endocrinol Diabetes Metab Case Rep. 2016;2016. pii: 16-0069. PubMed PMID:
27855229.
)).

===== Growth-hormone staining pituitary neuroendocrine tumor =====

[[Growth-hormone staining pituitary neuroendocrine tumor]]


====Craniopharyngioma====
A significant number of patients with [[craniopharyngioma]] are GH deficient. The safety of GH replacement in these subjects has not been established.