I. Idiopathic dwarfism: It refers to the short stature caused by no clear cause, including familial dwarfism, normal variant dwarfism and delayed puberty of physical growth.
Characteristics: 1. Apparently short in height (after 1 to 3 years of age); 2. Normal height and weight at birth, proportionate; 3. No chronic organic disease; 4. No significant or serious psychological or emotional disorders; 5. Normal feeding; 6. Normal chromosomal examination; 7. Normal bone age; 8. Slower or normal growth rate; 9. Growth hormone stimulation test: normal growth hormone secretion.
FDA (Food and Drug Administration) approved growth hormone for the treatment of idiopathic dwarfism in 2003.
2. Small for Gestational Age (SGA) 1. refers to children with birth weight or length significantly smaller than normal children of the same gestational age; 2. spontaneous catch-up growth occurs after birth, and SGA can mostly catch up with normal children of the same age at the age of 2. However, about 10% of children with SGA are still significantly short in height in childhood and adulthood; 3. children with SGA are eventually short if they still have persistent short stature after the age of 3; 4. If the height of children with SGA is still significantly lower than that of children of the same age after the age of 2, growth hormone treatment can be considered, and the earlier the treatment, the better the effect.
The goal of growth hormone treatment is to enable children to catch up with growth in early childhood, maintain normal growth in childhood, and reach normal adult height.
FDA approved growth hormone for SGA treatment in 2001.
Central precocious puberty is defined as the appearance of signs of present sexual development in girls at the age of 8 and in boys before the age of 9; 2. Precocious puberty + dwarfism: GnRHa combined with growth hormone treatment can effectively improve the predicted adult height.
D. Short stature due to congenital ovarian hypoplasia 1. Short stature (95%-100% of patients); Short stature is the only clinical manifestation of prepubertal period in children with congenital ovarian hypoplasia, which is very easy to be missed or misdiagnosed, therefore, karyotype analysis should be routinely performed for girls with short stature.
2. No signs of pubertal development (no breast development) in girls aged 14-16 years; 3. Uterus and ovaries are hypoplastic or absent.
FDA approved growth hormone in 1996 for the treatment of short stature due to congenital ovarian hypoplasia. The earlier the treatment, the better the lifelong height. The duration of growth hormone treatment is the most important factor affecting lifelong height, and most patients can achieve an adult height of 150 cm or more if they are diagnosed and treated early.
V. Prade r-Willi syndrome Characteristics: Short stature, with severe obesity, low muscle tone and gonadal dysgenesis.
In 2000, the FDA approved growth hormone for the treatment of short stature due to Prader-Willi syndrome, and weight control through diet and exercise.