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 gender or lower than the third percentile of the height curve of the population (in layman’s terms, it is the last three people in the queue of a hundred such children according to their size) medically it is called dwarfism. At the same time, growth less than 4~5 cm per year from age 3 to pre-puberty and less than 5~6 cm per year during puberty is called growth retardation. Since the diagnosis of dwarfism or growth retardation can be made, it means that it is pathological, i.e. there is a disease that affects growth and development, otherwise it is necessary to make a diagnosis of disease Both of the above conditions are pathological states, and many of them have been able to identify the causes at present. Common causes of dwarfism are: a. Endocrine dwarfism: such as growth hormone deficiency (we used to call it pituitary dwarf, but since dwarfism is discriminatory, we don’t use this name now, but it doesn’t mean there is no such disease. If growth hormone deficiency is not replenished in time, there are many dangers. It can cause not only dwarfism, but also osteoporosis, muscle and sexual dysplasia, susceptibility to aging, cardiovascular disease and metabolic abnormalities. Children with zinc and calcium deficiency need to be supplemented, why not growth hormone deficiency? (Only growth hormone deficiency is less obvious, unlike diabetics and insulin deficiency, which can be fatal immediately if not supplemented in time.) The diagnosis can be confirmed by growth hormone stimulation test and thyroxine test respectively. Low adult height due to precocious puberty also falls into this category. Unlike general dwarfism, precocious puberty can lead to higher height than peers during the growth period, but growth stops early and the final height is often shorter. At present, endocrine dwarfism can be treated very well.
II. Idiopathic dwarfism (including most hereditary dwarfism): If the cause of dwarfism cannot be identified by current medical means, it may be related to insufficient growth hormone activity or insensitive growth hormone receptors.
Nutritional dwarfism: Except for some of the more serious long-term chronic diseases, it is now rare. Mild malnutrition or general “picky eating” does not cause short stature (although many short people have poor appetite, often it is not the poor appetite that causes short stature, but because short people grow slowly, they need less and eat 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. In fact, sometimes a short period of hunger may also promote the secretion of growth hormone, why is a hungry tiger downhill more powerful than a well-fed tiger? Mild hunger can stimulate the secretion of many hormones. 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: affected children are born with low length and weight, and fail to show effective catch-up within six months to one year after birth, and their adult height is also low. Growth hormone can have some effect on such patients to improve adult height.
V. Chromosomal diseases: such as Turner syndrome, Down syndrome, etc., can be diagnosed by chromosomal examination. Depending on the type of disease, the treatment effect is different.
Sixth, genetic 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. If you suspect this type, you should have your bone age checked regularly and make an annual height prediction. This is because children nowadays are significantly more advanced in their development than previous generations. There are now many developed countries in the West that require children of normal growth period to have their bone age checked every two years.
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 a visit to the nutrition department, but a visit to the pediatric endocrinology department. Adults with endocrine disorders can also have endocrine disorders in childhood. If there is a difference of 3 or 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, even if it is late growth, it is impossible to catch up later. 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 first menstruation 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 and are found to be short, 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.