Q: Should I have my child examined if he or she is short?
A: Children between the ages of 4 and 12 who grow less than 5 cm per year are considered abnormal and should promptly go to a hospital specialist clinic (pediatric endocrinology) for consultation and treatment for further evaluation.
There are many causes of dwarfism, so to treat it, we must find out the cause and make a correct diagnosis, and then consider how to treat it. In order to find out the cause of the disease, we first need to go through medical history investigation, physical and laboratory examination, and based on detailed information and laboratory results, we will make a comprehensive analysis to determine the cause of short stature in children and finally determine the principle of treatment.
Q: What examinations should be done for short children and what preparations should be made before the examination?
A: Parents of children with short stature should provide the following information when they visit the hospital.
1. the mother’s pregnancy, and also the baby’s condition at birth, whether the birth was difficult, asphyxiation and what kind of delivery method was used, height and weight at birth, etc.
2. The annual rate of height growth, which is measured by removing the shoes.
3. Parents’ height and youth development, and whether there is short stature in the family.
4.Intellectual development, the presence of chronic hepatitis, kidney disease and asthma.
5.Whether drugs affecting growth and development have been used, such as prednisone (prednisone), dexamethasone and other glucocorticoids, etc.
When the child arrives at the hospital, blood and urine tests, liver and kidney function tests and thyroid hormone level tests are routinely performed, and karyotype analysis is done for girls. Next, x-rays of the left wrist and metacarpal fingers are needed to understand the age of the bones and to determine the growth of the bones, the degree of epiphyseal closure and the growth potential of the child.
If necessary, blood will be drawn to test the levels of growth hormone and growth factors. In addition, if short stature is considered to be growth hormone deficiency, a growth hormone stimulation test is required for diagnosis. MRI of the skull is performed in all children with short stature to rule out the possibility of congenital developmental abnormalities or tumors.
Please note: Some tests may require fasting, so please be careful to avoid eating before the test. In some cases, the results may not be available on the same day, so please consult your treating doctor for details.
Q: How much does it cost for a comprehensive checkup for children with short stature?
A: Short stature in children belongs to the category of pediatric endocrine diseases. Routine tests include: bone age, blood count, blood glucose, nail function, growth hormone, urine count, CT, liver function, kidney function and so on. A comprehensive examination in some hospitals in Guangzhou costs about 3,000 RMB, and usually costs more than 2,000 RMB.
Q: How do I know if growth hormone treatment for dwarfism is effective?
A: From the perspective of children’s growth and development, the growth of height is a relatively slow process, and it is impossible to achieve “instant results” after using the medicine. The criteria for determining the effectiveness of clinical growth hormone treatment for children with short stature is that an increase of more than 2 cm in the annual growth rate of the child compared to that before treatment is considered effective. Generally, 3 months of growth hormone treatment is a course of observation, and relatively obvious treatment effects can be seen in 3 months. It is normal for a child to grow more than 2 cm in 3 months of treatment.
It has been clinically proven that growth hormone treatment for children with short stature can effectively improve the growth rate of the child, thus improving his or her final height.
Q: What is the duration of growth hormone treatment?
A: The duration of growth hormone therapy should be determined according to the indications of the child, the difference in height compared to the normal standard, the condition of the bone age, and the family’s economic status, etc. In general, treatment should last at least 3-4 months to observe the efficacy. It is important to listen to the advice of the primary care physician and follow the doctor’s instructions for the specific treatment.
Q: Can I use growth hormone to treat short stature that is not caused by growth hormone deficiency?
A: There are many diseases that cause short stature in children, including idiopathic short stature (ISS) and intrauterine growth retardation (IUGR), which are often not caused by growth hormone deficiency, but are also indications for growth hormone as prescribed by the US FDA.
Precocious puberty can lead to suboptimal lifelong height in children, and the combination of growth hormone with treatment of precocious puberty can also improve lifelong height. Of all the indications, growth hormone deficiency is relatively the most effective treatment, with some children able to increase their annual growth rate by up to 12 cm/year.
Q: What is the best age to inject growth hormone for the treatment of children with short stature?
A: The earlier the treatment, the better. Treatment before puberty is the best time to treat. If a clear diagnosis has been made, treatment can be started after the child is 4 weeks old.