Date of Award

Spring 2022

Degree Name

Master of Medical Science (Physician Assistant)

Department

Physician Assistant; College of Health Sciences

First Advisor

Amanda Murphy, MS, PA-C

Abstract

The treatment of growth hormone deficiency (GHD) is well-established in childhood but less understood in adults, given the more complex role that growth hormone (GH) assumes in this population. Decreased functionality of the pituitary gland, otherwise known as hypopituitarism, can present with an isolated GHD in adulthood, which may result from a number of factors including neoplasm, ischemia, infection, traumatic injury, or systemic disease. Adult GHD may be definitively diagnosed with a stimulation test, the insulin tolerance test (ITT) being the study of choice. With a positive ITT, the disorder can be treated with growth hormone replacement therapy (GHRT), which typically consists of a daily subcutaneous injection. Adults who are treated with GHRT may expect a variety of positive outcomes including improved body composition, enhanced cardiac functioning, increased muscle mass, and better quality of life. Clinicians must be aware of potential adverse effects of this treatment, such as the development of a tumor or metabolic disease. Although these adverse effects are rare, individualized treatment plans and routine monitoring via labs and/or imaging are imperative.

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Management of Adult Growth Hormone Deficiency Related to Hypopituitarism

The treatment of growth hormone deficiency (GHD) is well-established in childhood but less understood in adults, given the more complex role that growth hormone (GH) assumes in this population. Decreased functionality of the pituitary gland, otherwise known as hypopituitarism, can present with an isolated GHD in adulthood, which may result from a number of factors including neoplasm, ischemia, infection, traumatic injury, or systemic disease. Adult GHD may be definitively diagnosed with a stimulation test, the insulin tolerance test (ITT) being the study of choice. With a positive ITT, the disorder can be treated with growth hormone replacement therapy (GHRT), which typically consists of a daily subcutaneous injection. Adults who are treated with GHRT may expect a variety of positive outcomes including improved body composition, enhanced cardiac functioning, increased muscle mass, and better quality of life. Clinicians must be aware of potential adverse effects of this treatment, such as the development of a tumor or metabolic disease. Although these adverse effects are rare, individualized treatment plans and routine monitoring via labs and/or imaging are imperative.