What are the current guidelines for the management of growth hormone deficiency in children?

Management of growth hormone deficiency (GHD) in children involves a comprehensive approach starting with accurate diagnosis, followed by individualized growth hormone (GH) replacement therapy and multidisciplinary care.

Diagnosis should be confirmed by endocrinology specialists using clinical assessment, auxological data, and biochemical testing including GH stimulation tests and measurement of insulin-like growth factor-I (IGF-I) levels to establish deficiency (Grimberg et al., 2016). Genetic testing may be considered in some cases to identify underlying causes (Collett-Solberg et al., 2019).

Once diagnosed, GH therapy is initiated with recombinant human growth hormone, tailored to the child's weight and clinical response, aiming to normalize growth velocity and improve final adult height (Grimberg et al., 2016). Treatment requires regular monitoring of growth parameters, IGF-I levels, and potential side effects, with dose adjustments as needed (Miller et al., 2024).

Multidisciplinary involvement is essential, including paediatric endocrinologists, dietitians, and psychological support to address the child's overall health and well-being (Collett-Solberg et al., 2019). Coordination with primary care teams ensures continuity and support for families.

Emerging therapies such as long-acting GH analogues (e.g., somapacitan) offer potential benefits in reducing injection frequency and improving adherence, though their use should be guided by specialist advice and current evidence (Miller et al., 2024).

In summary, current guidelines recommend specialist diagnosis, individualized GH replacement therapy with ongoing monitoring, and multidisciplinary care to optimize outcomes in children with GHD ¹ (Grimberg et al., 2016; Collett-Solberg et al., 2019; Miller et al., 2024).