Unlike people with achondroplasia, a genetic bone disorder, children with GHD have normal body proportions. Growth hormone plays a counter regulatory role in glucose regulation. Poor growth may be apparent by 6 months, but may not be obvious until 2 to 4 years of age. Glucose regulation is rarely a problem for the older child after the first year or two of life. However, undetected long-term hypoglycemia causes permanent intellectual impairment that becomes more obvious during the school years.
Chronic hypoglycemia is discussed later.
The nasal bridge is underdeveloped, and the nose is infantile. The cheeks are full and the chin petite. The hands and feet are small, and the skin is soft. Dental eruption is often delayed. Because cognitive development is not affected, children with normal developmental skills may appear precocious.