What are the common causes of short stature in children?
First of all, the most common is endocrine disorders that cause short stature. The first common cause is growth hormone deficiency, which is caused by the reduction of growth hormone secretion due to some primary or secondary causes, and can be diagnosed by growth hormone stimulation test. The second common cause is hypothyroidism. Currently, most regions in China perform heel blood screening after birth to detect hypothyroidism at an early stage, but this screening is not 100% sensitive and some cases may be missed; in addition, in some regions where screening is not performed, there may be some untreated hypothyroidism. After the diagnosis of hypothyroidism is confirmed, thyroxine tablets can be applied as replacement therapy. The third cause is precocious puberty. These children, due to early puberty, initially show earlier growth than other children and are taller than children of average age, but because height growth stops early, their final height is often shorter than that of other children. If parents can develop the signs of early puberty and intervene at an early stage, it can be corrected.
Second, some chromosomal disorders cause short stature. For example, Turner’s syndrome, the early manifestation of this disease is short, often accompanied by some abnormalities in other organs of the body, such as special facial deformities, elbow inversion, heart or kidney deformities, etc., and no secondary sexual characteristics appear at puberty, no first menstruation, etc. If a child is found to be short at an early stage, the diagnosis can be confirmed by chromosomal examination. After diagnosis, growth hormone treatment can be given to improve height, and estrogen replacement therapy can be given until puberty.
Third, intrauterine growth retardation. Some children are born with a length and weight below the minimum for a typical newborn, which is called intrauterine growth retardation or small for gestational age. In the first 2 years after birth, the majority of children can achieve growth catch-up and catch up with the height and weight of normal children. However, if a child fails to achieve growth catch-up during this period, he or she may often be at the lower limit of growth later in life and may have a lower adult height. Growth hormone treatment can also be applied to this cause of short stature, which can have a certain effect on improving adult height.
Fourth, disease or nutritional factors. Some children suffer from some serious chronic diseases, such as chronic hepatitis, kidney insufficiency, etc., which can also affect the height growth of children. There are also some rare children due to nutritional factors, but general picky eating is not so much to cause short stature, but only if serious nutritional deficiency will lead to height deviation from normal. The key is to effectively treat the original disease and adjust the nutrition.
Fifth, familial short stature leads to. This is short stature caused by hereditary genes. The child shows a normal growth rate per year, and most of them can also reach a height growth of 5cm per year, and the growth curve is parallel to that of normal children, but always at the low limit. Detailed medical history is taken and the child’s parents are often short or one of the parents is normal and the other is short. The child’s height is less than 2 standard deviations below the normal population, and the lifetime height is also at the lower limit of his or her target height. And there is no significant delay in bone age. Most lack effective treatments.
Sixth, delayed somatic growth and pubertal development result. This is the so-called “late growth”, and this group often has a family history. The growth rate of the child is basically normal in childhood, but after the age of puberty there is a developmental lag and a corresponding delay in bone maturity. At the same time, various pathological causes of delayed puberty need to be excluded. The child has no abnormal medical history, a normal physical examination, and normal laboratory screening tests. Those with this etiology generally do not require treatment and can eventually reach normal height.
Seventh, skeletal system diseases. Such as chondrodysplasia, osteogenesis imperfecta, etc. These diseases also have some corresponding clinical manifestations that can suggest the diagnosis.
Eighth, idiopathic dwarfism. There are also some children with short stature, which we call idiopathic dwarfism, because no clear cause has been found under the current examination conditions. These children can also be treated with growth hormone to improve their height, but the efficacy varies from person to person.