In 2009, the Society for Growth Hormone Research, the American Academy of Pediatric Endocrinology, and the European Academy of Pediatric Endocrinology reached an international consensus on the diagnosis and treatment of idiopathic dwarfism, which is summarized below.
I. What is idiopathic dwarfism?
Idiopathic dwarfism includes: familial genetic dwarfism, somatic growth delay, delayed puberty; 5, except for those with clear causes, such as chronic diseases, malnutrition and social and psychological factors. The dwarfism without any cause is idiopathic dwarfism.
The best time to treat children with dwarfism?
International and domestic pediatric endocrinologists suggest that the best age to start treatment for children with dwarfism is from 5 years old to early adolescence.
The diagnosis and treatment of children with dwarfism should be under the guidance of a pediatric endocrinologist.
2. Objective of treatment: Firstly, to achieve normal adult height; secondly, to achieve the standard height of normal children during childhood.
3. Ethical issues of treatment Because growth hormone is more expensive than ordinary drugs, and children diagnosed with dwarfism and needing treatment are already very short compared with children of the same age, the cost required to reach the standard height of normal children is also higher, therefore, measures to promote growth should not only be effective, but also must weigh the pros and cons.
In addition, height and efficacy should be monitored regularly during the treatment process, and the treatment plan and dosage of drugs should be adjusted. If an acceptable height has been achieved, or if the child does not want to continue the treatment when he/she grows up, discontinuation of drugs should be considered.
IV. Which children with idiopathic dwarfism need treatment?
1. Indicators of dwarfism: Children whose height is less than the 3rd percentile (P3) of the average of normal children of the same age and sex can be considered for treatment.
(Note: <3rd percentile (P3) (see the table of normal pediatric height standards on my webpage), i.e., <3rd percentile (below P3) is the lowest grade compared with normal children of the same age and sex, i.e., the predicted adult height for boys is less than 160 cm and for girls is less than 150 cm)] 2. The doctors generally do not advocate treatment for children and parents who do not mind their height, while those who are obviously troubled by short stature should be given medication or psychological treatment. V. Psychosocial status of children with short stature Children with short stature may result in childish behavior, be treated as young children, have impaired self-esteem, and are often bullied; children may often feel stressed, but rarely have real psychological problems.