Indications to test a child for growth hormone deficiency:
(1) height more than 3 standard deviations below the mean for the population (severe short stature)
(2) height more than 2 standard deviations below the mean for the population AND a growth velocity over 1 year more than 1 standard deviation below mean
(3) for child > 2 years of age, height more than 2 standard deviations below the mean for the population AND a decrease in the height standard deviation score more than 0.5 over 1 year
(4) height more than 1.5 standard deviations below the mid-parental height
(5) height velocity more than 2 standard deviations below the mean over 1 year in the absence of short stature
(6) height velocity more than 1.5 standard deviations below the mean over 2 years in the absence of short stature
(7) an intracranial lesion
(8) multiple pituitary hormone deficiencies
(9) neonatal history suggestive of growth hormone deficiency (unexplained hypoglycemia, prolonged hyperbilirubinemia, and hyponatremia with developmental defects in head and neck or genitals)
(10) following cranial irradiation
where:
• The standard deviation score (Z score) indicates the number of standard deviations above (positive number) or below (negative number) the mean.
• Measuring the mid-parental height would apply to adolescents or adults.
