Growth Hormone Replacement in Older Men Differential Diagnoses

Updated: Apr 14, 2020
  • Author: Angela Gentili, MD; Chief Editor: George T Griffing, MD  more...
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Diagnostic Considerations

Distinguishing idiopathic adult growth hormone deficiency (IAGHD) in older patients with no obvious pituitary lesion from hyposomatotropism of aging is challenging. The clinical features of adult GHD (eg, increased fat and decreased lean body mass, low energy, and mood disorders) are nonspecific and IAGHD may be misdiagnosed if based on the results of inaccurate single serum GH measurement. Because diagnosis requires costly repeat provocative testing, it has been proposed that evaluation be limited to the patients with history that includes one of the following risk factors [13] :

  • Surgery or radiation therapy for a pituitary or brain lesion

  • Hypothalamic-pituitary lesion, including pituitary adenoma, craniopharyngioma, cyst, hypothalamic tumor, or rare mass due to secondary tumor metastasis

  • Traumatic brain injury or treatment of a brain lesion

  • Systemic illness known to also impact the hypothalamic-pituitary axis including a granulomatous disorder; viral, bacterial, or fungal infections; or malignancy

Differential Diagnoses