Many patients with short stature do not have any other uncomfortable symptoms except for their short height. Since growth is slow, usual illnesses are rare, and most intellectual development is normal, parents often do not consider their children to be pathological. In fact, as long as the height is lower than two standard deviations from the average height of the same region, race, age and sex or lower than the third percentile of the height curve of that population (in layman’s terms, it is the last three of a hundred children of the same age and sex lined up according to their size) medically it is called dwarfism (attached table). Also growth less than 5 cm per year from age 3 to pre-pubertal and less than 6 cm per year during puberty is called growth retardation. Since the diagnosis of dwarfism or growth retardation can be given, it means that it is pathological, i.e. there are diseases that affect growth and development, and many of them have been able to identify the causes at present.
The common causes of dwarfism are: i. Endocrine dwarfism: such as growth hormone deficiency (in the past we called pituitary dwarf) and hypothyroidism, both of which can be diagnosed by growth hormone stimulation test and thyroid hormone test, respectively. Low adult height due to precocious puberty also falls into this category. Currently, endocrine dwarfism is treated very well.
Idiopathic dwarfism (including most hereditary dwarfism): i.e., the cause of dwarfism cannot be detected by current medical means.
Nutritional dwarfism: Except for some chronic diseases of liver and kidney, it is rare at present. Mild malnutrition or general “picky eating” does not cause short stature (although many people with short stature have poor appetite, often it is not the poor appetite that causes short stature, but the fact that people with short stature grow slowly and eat less because they need less. Why does children’s appetite often increase when they enter puberty? It is mainly because of accelerated growth and increased needs), and it is only long-term severe malnutrition that affects height. Such patients do not need height increasing treatment, as long as the effective treatment of the original disease, adjust the nutrition can grow taller.
Fourth, intrauterine growth retardation: the affected children were born with low length and weight, and failed to show effective catch-up within six months to one year after birth, and their adult height is also low.
V. Chromosomal disorders: such as Turner syndrome and Down syndrome, which can be diagnosed by chromosomal examination.
Sixth, inherited metabolic diseases: such as stupid acetonuria, mucopolysaccharidosis. Such patients are currently poorly treated for augmentation.
Seven, physical puberty delay: the so-called “late growth”, this category of people often have a family history, generally do not need treatment, and eventually can reach normal height.
Eight, skeletal system diseases: such as chondrodysplasia, osteogenesis imperfecta, etc..
In addition, there are some rare diseases such as: renal rickets, cranio-cerebral injury, tumors, etc.
Nowadays, many parents and even some medical professionals have some misconceptions about short stature. They think that short stature is either “malnutrition” or “late growth”. In fact, enhancing nutrition will not improve the height of patients with dwarfism. The treatment of dwarfism is not in the nutrition department, but in the child growth and development clinic. If there is a difference of 3-5 cm, it is possible to catch up with the late growth (meaning that the development of youth is significantly later than that of the same age), but if there is a difference of 20 cm, it is impossible to catch up with the late growth even if it is late. There are even some parents who ignore the fact that their children have already shown obvious signs of development or that girls have already had their menarche and boys have already changed their voices or spermatorrhea, and blindly consider it as late growth. In our clinic, we often encounter people who come to seek treatment only when their children do not grow up and find out that they are short in stature, but it is too late at that time. Therefore, when you find out that your child is short in stature, you should not just wait, you should do the corresponding examination in time, the earlier the treatment, the better the effect.