GROWTH ABNORMALITIES: CONTEMPORARY ISSUES IN ENDOCRINOLOGY AND METABOLISM Edited by Raymond L. Hmtz ancJ Ron G. Rosenfeld New York. Churchill Livingstone, 1987, vol. 4, 281 pp. $42.00
This book gives an excellent overview of abnormalities in growth. Editors Raymond L. Hint: and Ron G. Rosenfeld have chosen and organized the chapter topics in a logical manner.
The opening account ot the physiology of growth provides a firm basis tor the rest of the collection. The second chapter reports on current basic-science studies on growth hormone and the hypothalamic releasing hormone, and the third chapter is an intorniati ve presentation ot clinical issues in growth hormone deficiency. Alterations ot growth pattern in diabetes mellitus are next examined, with mention of the effects on glycemie control and vascular complication attributable to the growth hormone-somatomedin axis. A chapter enumerating non-endocrine causes of abnormal growth i,s followed by a well-tabulated article on growth failure not due to growth hormone deficiency, which reservedly considers the applicability of growth hormone therapy in these cases. Also at this central point is a report on clinical results and future applications ot synthetic growth hormone, prefaced with a very readable capsule synopsis of the recomhinant DNA techniques employed in its production. After surveys ot delayed puberty and constitutional delay, the article on Turner's syndrome places short stature in context within the intricate array of effects seen in this chromosomal disorder.
Essential to the theme of abnormal growth is a chapter on excessive growth and tall stature, which summarizes the nature and management ot these less often encountered conditions. The two concluding chapters are an extensive summary of great practical benefit on the laboratory tests used in the diagnosis of growth disorders, with specific emphasis placed on the assessment of growth hormone secretion; and an examination of psychological aspects of growth problems for patient, family, and physician. Attention to this final concern, however, seems generally evident throughout this volume, the contributors ably acknowledging the importance of psychological factors in the clinical presentation of many cases of problems in growth. In addition, one finds in most chapters specific practical recommendations concerning laboratory data - the tests to be performed, the variability of results and the cautions to be exercised in interpretations.
Much statistical material is offered in this book that will be of basic use in clinical evaluations as well as give a sense of the relative prevalence of many causes - both defined etiologies and non-specific factors - of abnormal statural variation. Growth Abnormalities will certainly well serve the endocrinologist and general pediatrician in clinical practice.