Sho stature, secondary to growth hormone deficiency is associated with
sho stature : Defined as height below third centile or more than 2 standard detions below the median height for age and gender according to the population standard. Children whose stature s more than 3 SD below the population mean for age and gender are more likely to be suffering from pathological sho stature as compared to those with stature between -2 and -3SD , who are more likely to be affected by familial or constitutional sho stature. CAUSES:- 1. Most common cause is constitutional. 2. Familial 3. Pathological causes include: Undernutrition Chronic systemic illness Cerebral palsy Congenital hea disease Cystic fibrosis,asthma Malabsorption Acquired immunodeficiency syndrome 4. Endocrine causes include: Growth hormone deficiency Hypothyroidism Cushing syndrome Pseudohypoparathyroidism Precocious or delayed pubey 5. Psychosocial dwarfism 6. Children born small for gestational age. 7. Skeletal dysplasia; achondroplasia, rickets. 8. Genetic syndrome; Turner, Down syndrome. Growth hormone deficiency:- Growth hormone deficiency may be caused by congenital CNS malformations, genetic defects or acquired neurological insults. These children have normal growth at bih. Growth retardation become apparent around 1 year of age. Midfacial crowding, round facies, mild obesity,depressed nasal bridge,single central incisor tooth and micropenis are common. Body propoions are normal. Development of tooth delayed.Facial appearance is doll like. These children look much younger than their actual age. Bone age is delayed. Newborns may present with severe hypoglycemic seizures due to concomitant ACTH deficiency. Reference: GHAI Essential pediatrics, 8th edition
Normal body propoion
Low bih weight
Normal epiphyseal development
Height age equal to skeletal age
Growth and development