Epidemiology and Etiology

In the United States, GH deficiency affects approximately 50,000 adults, with around

6,000 new cases diagnosed annually. Approximately 10,000 to 15,000 children have growth failure owing to GH deficiency. Children may present with GH deficiency at any time during their developmental stages. The evaluation for GH deficiency in a short child should be deferred until appropriate exclusion of other identifiable causes of growth failure, such as hypothyroidism, chronic illness, malnutrition, genetic syndromes, and skeletal disorders. Also, several medications, such as methoxamine, iso-

proterenol, glucocorticoids, cimetidine, methylphenidate, and amphetamines, may in-

duce GH insufficiency.

Table 46-3 Assessment of Acromegaly Complications at Diagnosis and Follow-Up

At the Time of Diagnosis During Long-Term Follow-up

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