I. Idiopathic dwarfism: Short stature due to no clear cause, including familial dwarfism, normal variant dwarfism and delayed puberty.
Characteristics: 1) Significantly short height (after 1 to 3 years of age); 2) Normal height and weight at birth and proportionate; 3) No chronic organic disease; 4) No significant or severe 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 2 years of age, but about 10% of 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 3 years of age; 4. children with SGA After 2 years old, if their height still lags significantly behind that of children of the same age, they can be considered for growth hormone treatment, and the earlier the treatment, the better the effect.
The goal of growth hormone treatment: to enable children to achieve catch-up 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 before the age of 8 years for girls and 9 years for boys; 2. Developmental progression, slowing down the maturation rate of bone age, thus providing patients with more room for growth; 5. Precocious puberty + dwarfism: GnRHa combined with growth hormone treatment can be used to 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, and it is very easy to be missed or misdiagnosed. Therefore, karyotype analysis should be routinely performed for all girls with short stature.
2. No signs of pubertal development (no breast development) in girls aged 14-16 years; 3. Uterus and ovaries hypoplasia or absence of uterus and ovaries.
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 if early diagnosis and early treatment can be made, most patients can achieve an adult height of 150 cm or more.
V. Prade r-Willi syndrome Characteristics: Short stature, with severe obesity, low muscle tone and gonadal dysgenesis.
In 2000, the FDA approved the use of growth hormone for the treatment of short stature due to Prade’r-Willi syndrome, as well as weight control through diet and exercise.