short stature
Introduction
Introduction to short stature The so-called short stature or short stature means that in a similar environment, the height is 2 standard deviations (-2SD) or less or below the 3rd percentile than the average height of children of the same race, same sex, and same age. The main causes of children's short stature are: non-endocrine-deficient short stature, familial idiopathic short stature, delayed puberty, and malnutrition. basic knowledge Sickness ratio: 0.0001% Susceptible people: children Mode of infection: non-infectious Complications: asymmetrical body in children - dwarf - sexual dysplasia syndrome
Cause
Short stature
Growth hormone deficiency (25%):
Pituitary dysplasia such as: forebrain non-cracking malformation, visual a septal dysplasia, fissure, hypothalamic dysplasia blastoma. Growth hormone, growth hormone release hormone deficiency. Idiopathic growth hormone deficiency, some patients with pituitary dysplasia. Growth hormone receptor-deficient laron syndrome. Defective insulin-like growth factor 1 (IGF1).
Genetic factors (20%):
Autosomal recessive type I: IA type GHI gene deletion; IB type CHl and other gene mutations, growth hormone releasing hormone receptor gene mutation.
Autosomal most inherited type II: GHI and other genetic variants.
X-linked genetic type III.
Head injury (15%):
Perinatal injury (breech production, ischemia and hypoxia, intracranial hemorrhage, etc.); skull base fracture, radiation damage, inflammation sequelae, etc.
Brain infiltration lesions such as: tumor, Langerhans cell histiocytosis.
Other factors (10%):
Smaller than gestational age, growth hormone neurosecretory dysfunction, mental and psychological short stature, chromosomal aberrations, skeletal development disorders, chronic systemic diseases, etc.
Prevention
Short stature prevention
It is necessary to have a normal balanced diet and eat less snacks so as not to cause adverse effects on your child's health. Although proper diet is good for growing up, don't be too superstitious about these aspects without treating related diseases.
Complication
Short stature complications Complications Children's asymmetrical body-dwarf-sexual dysplasia syndrome
Infection, trauma, severe vomiting, diarrhea and other stress, and even pituitary crisis.
Symptom
Short stature symptoms common symptoms slow growth muscle dysplasia bones stop developing
Slow-growing signals have a regular growth and growth rate in puberty. After puberty, the bones mature, the epiphyseal line is closed, the height is no longer growing, and the child can not continue to grow taller by any means. Many parents can only regret for life because they missed the best time to treat their children. This requires parents to pay close attention to the child's growth status, and to find out in time the child's slow growth signal:
1. The growth rate of children is less than 7 cm/year before 3 years old.
2, 3 years old to puberty less than 5 cm / year.
3, puberty is less than 6 cm / year.
Examine
Short stature examination
Physical examination
Body measurements should include height, weight, sitting height, finger distance, head circumference, etc. Observe whether the physical development of the sick child is symmetrical, head, trunk, limbs, finger size and shape. The distribution of the five senses, the face is not special. Distribution of subcutaneous fat, muscle development, muscle tone, joint ligament activity, sexual development. In addition, the following items should be measured and recorded correctly:
1) The measured value and percentile of the current height and weight.
2) The annual growth rate of height (at least 3 months).
3) Target height measured according to the height of their parents.
4) BMI value.
5) Sexual development staging.
Laboratory inspection
1) X-ray examination:: Short children need to take a left-handed X-ray to determine the bone age. Under normal circumstances, the difference between bone age and actual age should be between ±1 years old.
If the patient is not well-balanced and suspected of having a bone lesion, the X-ray film should be further examined, including the spine, pelvis, and thorax. If necessary, include the upper or lower limbs, and observe the growth of the bone. The density of the bone may be preliminary. Defining the diagnosis of bone disease.
2) routine examination: blood, urine routine examination, liver and kidney function and blood biochemistry, electrolytes, blood gas examination, blood calcium, phosphorus, zinc, alkaline phosphatase determination.
3) Chromosome examination: If the girl is short or has mild deformity, a cell chromosome examination should be performed to determine whether it is Turner syndrome.
4) Endocrine examination:
(1) Thyroid function: Serum T3, T4 or TSH is measured.
(2) Growth hormone-insulin-like growth factor I axis (GH-IGF-I) function assay.
Diagnosis
Diagnosis of short stature
Because of the many causes of short stature, children with short stature must be thoroughly examined (including detailed medical history enquiries, comprehensive physical examinations, and laboratory tests). Body measurements should include height, weight, sitting height, finger distance, and head. Waiting. Observe whether the physical development of the sick child is symmetrical, head, trunk, limbs, finger size and shape. The distribution of the five senses, the face is not special. Distribution of subcutaneous fat, muscle development, muscle tone, joint ligament activity, sexual development. Identify the reasons for treatment.
