Many parents always worry about their babies growing slower than other children, but few people think that this may be caused by dwarfism. If a child is short in stature, treating or not treating it can have a huge impact on the child’s life, so you need to identify the cause and treat it early, and grab the height of the epiphysis.
The difference between treating and not treating short stature is huge. Li, 26 years old, from Zaozhuang, Shandong Province, is known as “China’s tallest dwarf”. He has a handsome face, clear and bright eyes, and a height of 176 cm, but who would have thought that he was only 106 cm when he started treatment at the age of 13. In stark contrast to Li, Lu from Shanghai, 33 years old, but only 116 cm tall.
Lu, who graduated from university with a bachelor’s degree and an eighth grade in English, is known as a pocket-sized talented woman, the editor of the public welfare website “Growth and Development Network”, and the initiator and promoter of the national “Dwarf Fellowship”. In 2011, Lu entered the marriage hall.
“My biggest regret is that I missed the best treatment period because of the lack of knowledge of dwarfism treatment in those days, and I could never grow taller! Lu said that at the age of 2 there was a big gap between her height and that of children her age, but she was always considered malnourished and sought medical help for several years before being diagnosed with growth hormone deficiency.
“I used foreign growth hormone for a period of time when I was a child and grew 27 cm taller, but because of my family’s financial ability, I couldn’t use the medicine again and my height stopped at 110 cm and didn’t grow. Later, I used domestic growth hormone and grew 6 centimeters taller, and 5 years ago I couldn’t grow any taller because my epiphysis was completely closed.” Lu said.
Once I saw Ma Quanfu, the reporter thought he was an elementary school student, but in fact he has graduated from the Department of Art and Design of Yantai Vocational College. From the second grade he was 10 cm shorter than his peers, his father took him to the county hospital, the doctor said it may be late growth. By the fourth grade, Xiao Ma was 105 cm, 40 to 50 cm shorter than his classmates. Over the years, he sought medical help everywhere and also fell for it many times. Finally he found the cause of his short stature: because of a difficult birth, he had a lack of growth hormone and androgen production. After 8 months of treatment with growth hormone, Ma Quanfu grew from 130 cm to 142 cm, but due to his family’s bad situation, the harvest of his family’s only few mu of land could not afford the treatment, Ma Quanfu had no choice but to terminate the treatment, and his height stopped at 142 cm forever.
According to the report, the standard deviation method and height percentile method are used to determine short stature clinically, that is, a child’s height is lower than the 3rd percentile or lower than two standard deviations of the normal height standard for children of the same age, gender, region and race, then it can be diagnosed as dwarfism. In other words, if 100 children of the same sex and age are lined up from high to low, those who are below the last 3 are considered to be of short stature.
Slowed growth rate is often one of the early signs of childhood diseases. Every pediatrician, parent and teacher should pay attention to accurately measuring the height and weight of their children for early detection of problems. The growth rate of normal children varies at different times, generally 50 cm at full-term birth, less than 47 cm indicates intrauterine growth retardation; 25 cm growth in the first year after birth, 10 cm in the second year, 5-7 cm per year on average from the third year to the beginning of puberty, and 8-12 cm per year during puberty for 2-3 years. the formula for estimating height between 2 and 12 years is: age x 7 + 70 cm, generally less than 7 cm per year before the age of 3, less than 5 cm per year between the age of 3 and puberty, and less than 6 cm per year after puberty, the growth rate is considered slowed. Prompt medical consultation and early treatment should be provided.
There are many causes of pediatric growth deficiency and adult short stature, including growth hormone deficiency, hypothyroidism, precocious puberty, as well as children younger than fetal age, idiopathic dwarfism, systemic diseases, somatic growth and delayed puberty, etc. Short stature should be treated by a pediatric endocrinologist, not blindly.
The incidence of dwarfism has increased in recent years. According to a survey in 1987, the incidence of dwarfism among 103,753 primary and secondary school students in urban areas of Beijing was 0.19%, of which pathological dwarfism accounted for 14.3%. In Shanghai, a survey conducted in 2007 on 70,431 primary and secondary school students aged 6-18 in the suburbs showed that the incidence of dwarfism was as high as 3.77%, and the incidence in Jinan was 4.3%.
According to the report, the pediatric department of a hospital has treated 21460 patients with dwarfism in the past 10 years, while only 3960 were treated, accounting for only 18% of the treatment. The earlier dwarfism is treated, the better the results and the less money it costs. A child with a weight of 20kg spends 20,000-40,000 yuan a year for treatment, while a 60kg dwarf patient spends 60,000-1600,000 yuan a year, and the results are not as good as the former.
The happy life of the seven dwarfs and Snow White can only happen in fairy tales, but in real life, there are too many problems caused by short stature.
First, the physical and mental development of people with dwarfism is greatly affected. Compared with normal children, although their IQ is within the normal range, most of them have psychological introversion, emotional instability, poor communication and social withdrawal. A survey in Shanghai shows that more than 90% of children with dwarfism have different psychological disorders such as low self-esteem and depression, and some children are even reluctant to go to school because of their short stature.
In addition, the defective stature also directly affects their education, employment and marriage. Lujarui confided in the reporter about the troubles of their group, “Many of us were rejected almost at first when we went to elementary school, secondary school, university and when we were looking for jobs.” Ma Quanfu told the reporter that he hopes the society will provide more employment opportunities for dwarf people so that they can also contribute to the society with their intelligence.
0-3 years old Regular monitoring is not to wait for children’s dwarfism is not terrible, what is terrible is that many parents do not understand the relevant knowledge and do not pay attention to the problem of short stature of their children. More than half of parents do not know that they need to observe their children’s height from 0-4 years old; more than 1/3 of parents do not have the habit of scientifically measuring their children’s height; 30% of parents mistakenly believe that their children’s height can catch up as long as they keep up with nutrition; more than 70% of parents lack sufficient understanding of dwarfism and do not think that dwarfism may be a disease. After they find out that their children are short, they stick to the misconceptions of “late development” and “twenty-three scurrying” and wait blindly.
Therefore, it is recommended that parents should measure their children’s height once every two months. If they are always in the top three in the class line, or if they are 5-10 cm shorter than children of the same age, parents should pay attention to them. Parents should take their children to the pediatric endocrinology clinic of a regular hospital to seek professional doctor’s intervention at the first time they find out that their children are short. Don’t delay the best time for your child’s treatment and cause tragedy to your child’s life by seeking medical help in a hurry or believing in advertisements.
The age of starting treatment varies from disease to disease. For growth hormone deficiency, treatment should be started as early as possible after diagnosis. 4-6 years old is the appropriate age for other indications of growth hormone treatment, such as idiopathic short stature and small for gestational age children, and it is more appropriate to start treatment from the age of 4.
Domestic treatment for dwarfism is received relatively late, with 70% of the age group being between 11-16 years old. In contrast, the average age of treatment abroad is 6 years. Starting treatment at an older age contributes less to adult height, and early treatment can maximize the adult height of the affected child. In general, if the bone age of a girl is over 15 years old, and if the bone age of a boy is over 17 years old, the epiphysis is mostly closed by then and the chances of growing taller are very small. Therefore, the earlier the epiphyseal closure is understood, the earlier the intervention can be carried out, and the better the intervention can be. As long as the treatment is timely, the child can usually have a normal height.
“We often encounter children who are 16 or 17 years old when they come to the clinic, and their epiphyses are already closed according to the bone age film, so we are helpless as doctors. Like Lujarui, it is a very unfortunate example of missing the treatment period, resulting in lifelong dwarfism.”
In contrast, Li Xiang was much more fortunate, as he began to receive domestic Saizen growth hormone treatment in 2000, and after six years of treatment, he grew 70 cm, fully reaching the height of a normal person.
The greatest effect of growth hormone replacement therapy that can lead to improvement in the final height of a patient with dwarfism is in the first year, when the most can grow 21 cm in a year. Treatment is usually stopped after epiphyseal closure, and it is important to adhere to the medication during the treatment process and never stop it on your own.
In addition, parents should also be reminded that in order for their children to grow taller, they should also live with a diet that is nutritious, sleep early and exercise more.