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Growth hormone deficiency — MRCPCH FOP MCQ

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HardEndocrinology and growthGrowth hormone deficiencyMRCPCH FOP

A 7-year-old boy has height crossing down centiles with increased weight centile. He has recurrent early morning headaches and bitemporal visual field difficulty on confrontation. What is the most appropriate investigation?

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Correct answer: E — MRI pituitary and brain with endocrine referral

Poor linear growth with weight gain suggests endocrine pathology, and headaches plus visual field symptoms raise concern for a sellar mass affecting growth hormone. Starting growth hormone before imaging would be unsafe. Coeliac disease can impair growth but does not explain bitemporal visual symptoms. The pearl is that increased weight with falling height centile points towards endocrine rather than nutritional disease.

Reference: BSPED growth disorder guidance; RCPCH growth charts