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Growth hormone deficiency — RACP Paediatrics MCQ

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HardEndocrinology and growthGrowth hormone deficiencyRACP Paediatrics

A 5-year-old has height below the 1st centile and growth velocity has slowed over two years. Weight is relatively preserved, bone age is delayed and IGF-1 is low. He had neonatal hypoglycaemia and prolonged jaundice. What is the most likely diagnosis?

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Correct answer: E — Growth hormone deficiency

Poor growth velocity with preserved weight, delayed bone age and low IGF-1 suggests growth hormone deficiency, especially with neonatal hypoglycaemia and jaundice suggesting pituitary dysfunction. Familial short stature usually has normal growth velocity and bone age closer to chronological age. Auxology over time is more informative than a single height measurement.

Reference: RACP Knowledge Guides; Australian growth assessment guidance