What are the causes of short stature

Short stature

Short stature , or dwarfism, or stunting , all terms used the child to describe the minimum length of the length of most children in the same age and sex, and more specifically , it is called a child who is equal in length percentiles III or It is less than that in the growth chart , and it is worth noting that the growth chart is a tool that the doctor uses to monitor the growth of a child compared to the rate of growth of children. ^{[1] [2]} It is important to note that growth depends on a group of Factors include genetics, nutrition and the influence of hormones. Short stature in itself is not a disease but rather a result of a specific health condition. ^{[3] [4]}

Causes of short stature

Short stature in some cases may be a kind of normal growth, and in some other cases it may indicate the presence of a specific problem or disorder, and the causes can be explained in some detail as follows: ^[4]

Natural short stature

Most cases of short stature that are not caused by a specific disease are considered normal, as the child enjoys good health and eventually grows at a normal rate, and the underlying cause of normal short stature in most cases is unknown, or it may result from less than average stature, or a delay In puberty in family history, as there are two types of differences, including these common conditions, as they will be detailed, which appear in natural alternative growth patterns for children and do not indicate the presence of developmental disorders or health problems. ^{[2] [5]}

Delayed structural growth

Constitutional growth delay describes children who are short for their age but grow at a normal rate, as they do not have any symptoms or signs indicating the presence of certain diseases that in turn affect the rate of growth, but they appear to have a delay in the age of the bone This means that their skeletal maturity is younger than their age in years, and in the context of the conversation, the age of the bone is calculated by taking an x-ray of the hand and wrist and comparing it to the standard images that are taken for children of the same age, and it is also delayed Puberty in these children compared to their peers in terms of sexual development and growth spurt upon puberty, however, their growth continues until an older age and thus they reach the normal height of their peers in adulthood, and it is likely that one or both parents or one of the relatives went through a similar growth pattern, ^[5] for example A female relative may have gone through her first menstrual cycle after reaching the age of 15, or a male relative may have reached his final height after reaching the age of 18. ^[6]

Hereditary short stature

Children with familial short stature grow at a normal rate, and one or both parents are short, and their bone grows normally, given the age-matched bone age, and these children reach puberty at its normal time and complete their development completely With a length commensurate with the height of the parents' stature, the specialist may request some laboratory tests, and some of them never resort to them, and in most cases the result is normal in the required tests. ^{[6] [7]}

Health problems and illnesses

There are many growth problems that exist according to the type of growth disorder present, some are linked to genes, while others are related to problems with hormones or poor absorption of food, and what follows is a detail of all these disorders. ^[8]

Malnutrition

Malnutrition results from not obtaining an adequate amount of food or due to some systemic diseases that affect the body's access to its needs of food, increase its need for energy, or interfere with the ability to absorb food, and this is in addition to the fact that some may It imposes self-restrictions on food for fear of obesity, and in the end, continuous malnutrition causes short stature and prevents children from fully completing their growth, and it is worth noting that malnutrition is the most common cause of growth problems in the world, and therefore it is advised to obtain healthy, balanced food for prevention It is treated and treated, and the deficiency characteristic of nutritional deficiency is low weight relative to height. ^{[8] [9]}

Endocrine diseases

Primary endocrine disorders that have effects on growth are uncommon, but it is important to identify them because they are treatable, and in general these disorders, which will be detailed by excess weight relative to height, are explained below: ^[9]

• Growth hormone deficiency: The growth hormone is a protein produced by the pituitary gland located near the base of the brain and the associated area of the hypothalamus , which in turn regulate the work of the pituitary gland, and therefore any damage It may affect the hypothalamus or the pituitary gland, affecting in turn the production of growth hormone, ^[10] and growth hormone deficiency usually results in abnormally slow growth with normal short stature. ^[11]
• Hypothyroidism: play thyroid hormones an important role in the normal growth of bones and regulate both weight and energy levels, and internal temperature, the growth of skin, hair, nails, etc., and thus cause a lack of secretion of thyroid hormones caused by hypothyroidism ( Hypothyroidism is short stature. ^{[12] [13]}
• Cushing 's syndrome associated with Cushing 's syndrome or as it is sometimes called hypercortisolism exposure of the body to high levels of the hormone cortisol for a long time, which may occur as a result of taking medication corticosteroid by mouth Oral corticosteroid or because the body produces more cortisol on its own, ^[14] and one of the primary symptoms of Cushing's syndrome in children is short stature while continuing to gain weight. ^[15]

chronic diseases

Chronic diseases associated with the pituitary gland may affect growth.For example, cancer treatment may affect radiation to the brain in the pituitary gland in children, causing short stature, and some diseases of the gastrointestinal tract, such as inflammatory bowel disease and celiac disease Celiac disease, or as it is known as short stature wheat allergy, due to its effect on nutrition, and other chronic diseases may be associated with slow growth such as heart disease, kidney disease, immune diseases, and other endocrine diseases. ^[16]

Congenital problems

Infection with some congenital problems may lead to short stature in children, because they mainly affect the tissues in which growth occurs, and while these problems are explained in some detail: ^[8]

• Growth inside define the womb: , this problem occurs as a result of a number of genetic and environmental factors that lead to non - completion of intra - uterine growth, ^[17] and usually lengths and weights of these children at birth is less than normal and proportional to the Palace Stature. ^[18]
• Chromosome abnormalities: , the presence of more or less chromosomes is the cause of many health problems, which include problems associated with growth, and the details of which come: ^[8]
  • Turner syndrome: It is a genetic disorder that results from the loss of the X chromosome in all cells of the body, and usually affects females and causes their short stature as well as sexual immaturity at puberty, and the severity of the problems associated with it varies among individuals, and it may be accompanied by problems Others include heart and kidney problems that can be controlled in many cases. ^[19]
  • Down Syndrome: , produces Down syndrome due to the presence of genetic material trailing in chromosome number 21, it is worth mentioning that the child size is usually normal rate, but it grows slower stays shorter than his peers, and to this side caused many Down 's syndrome Among the deformities, health problems and cognitive impairment, it is worth noting that the phenotype is variable, and the severity of cognitive impairment also varies, ranging from mild and moderate to severe. ^{[20] [21]}
  • Noonan syndrome: Noonan syndrome results from changes in one of the dominant genetic genes. It may occur during pregnancy, ^{[22] and} in the context of the conversation, it is indicated that Noonan syndrome affects many parts of the body, causing unusual facial features, short stature, heart problems, bleeding problems, and deformities in the skeleton, among others. ^[23]
  • Russell-Silver syndrome: It is a rare condition associated with the presence of specific problems in the genes responsible for controlling growth, while it may be difficult to identify the genes responsible at times for causing developmental problems before and after the birth of a child, and the symptoms of these vary The syndrome includes low birth weight , short stature, distinctive facial features, large head size relative to body size, body asymmetry, and feeding difficulties, and it is worth noting that in most cases it is not inherited, while it may be inherited in rare cases with a dominant or recessive pattern. ^[24]
• Precocious puberty: Precocious puberty occurs when the signs of puberty appear in females younger than 8 and in males younger than 9 years old. ^[25] Since puberty occurs at a younger age than usual, the growth of these children usually depends on the age of Smaller, sometimes causing shorter stature. ^[26]
• Skeletal abnormalities: There are more than 50 types of diseases that affect the bones , which in turn affect growth and height, and many of them are related to genetic causes, the most common of which is Achondroplasia, which is one of the types of dwarfism or dwarfism And in which the child's arms and legs are short in relation to the length of the body with the size of the head often large, in addition to the normal size of the trunk ^[18]

Stress

Loss of care for children, or their exposure to violence resulting from wars or famines, or being in a home environment that is not properly fed may cause psychological stress that prevents them from developing normally, and from the good news, it is referred to as the ability to change this state if children get rid of the causative environment For psychological stress. ^[16]

pharmaceutical

Growth in children may be affected by some treatments, such as radiation therapy that has a lasting effect, glucocorticoids, stimulant drugs used in the treatment of attention deficit disorder (ADD), and chemotherapy, which usually has a temporary effect. And it may be permanent in some cases that require long-term treatment. ^[9]

Idiopathic short stature

Idiopathic Short Stature is defined as apparent short stature compared to peers of the same age and sex, with short stature expected after puberty without being able to identify any cause behind it, and it has been found that the problem of idiopathic short stature affects all females And males are of the same level, and despite ignorance of the reasons, treatment with growth hormone may be useful in some children. ^[27]

References

1. ↑ "Short Stature" , www.childrensmercy.org , Retrieved 2020-4-22. Edited.
2. ^ ^{A b} "Growth , & Short Stature disorders" , Www.rileychildrens.org , Retrieved 2020-4-22. Edited.
3. ↑ "When should doctors treat short children and teens with growth hormone?" , www.sciencedaily.com , 2017-1-25, Retrieved 2020-4-22. Edited.
4. ^ ^{A b} Yvette Brazier (2017-5-16), "What ' Is Short Stature, And Is It Treatable?" , Www.medicalnewstoday.com The , Retrieved 2020-4-22. Edited.
5. ^ ^{A b} "What Is a Growth Disorder?" , kidshealth.org , 2014-7, Retrieved 2020-4-22. Edited.
6. ^ ^{A b} of Robert Ferry , Jr. (2019-2-1), "In Short Stature Children" , Www.emedicinehealth.com , Retrieved 2020-4-22. Edited.
7. ↑ “Constitutional Growth Delay and Familial Short Stature: A Guide for Families” , www.pedsendo.org , Retrieved 2020-4-22. Edited.
8. ^ ^{A b T w} "Pediatric Short Stature" , Childrensnational.org , Retrieved 2020-4-23. Edited.
9. ^ ^{A b v} Erick J Richmond Richmond, Alan D Rogol (2020-4-2), "Causes Of Short Stature" , Www.uptodate.com , Retrieved 2020-4-23. Edited.
10. ↑ "Growth Hormone Deficiency Symptoms & Causes" , www.childrenshospital.org , Retrieved 2020-4-23. Edited.
11. ↑ Andrew Calabria (2018-10), "Growth Hormone Deficiency in Children" , www.msdmanuals.com , Retrieved 2020-4-23. Edited.
12. ↑ "Growth Problems" , www.stanfordchildrens.org , Retrieved 2020-4-23. Edited.
13. ↑ "Thyroid Hormones" , www.hormone.org , 2018-12, Retrieved 2020-4-23. Edited.
14. ↑ Mayo Clinic Staff (2019-5-30), "Cushing syndrome" , www.mayoclinic.org , Retrieved 2020-4-23. Edited.
15. ↑ "Cushing's Syndrome" , www.chop.edu , Retrieved 2020-4-23. Edited.
16. ^ ^{A b} "Short Stature (Growth , disorders) In Children" , Www.yalemedicine.org , Retrieved 2020-4-23. Edited.
17. ↑ George T Mandy (2019-11-11), “Infants with fetal (intrauterine) growth restriction , ” www.uptodate.com , Retrieved 2020-4-24. Edited.
18. ^ ^{A b} "Growth , Problems & Causes the Symptoms" , Www.childrenshospital.org , Retrieved 2020-4-24. Edited.
19. ↑ "Turner syndrome" , chw.org , Retrieved 2020-4-24. Edited.
20. ↑ Colin Tidy (2016-10-4), "Down's Syndrome" , patient.info , Retrieved 2020-4-24. Edited.
21. ↑ Mayo Clinic Staff (2018-3-8), "Down syndrome" , www.mayoclinic.org , Retrieved 2020-4-24. Edited.
22. ↑ "Noonan Syndrome" , www.genome.gov , Retrieved 24-4-2020. Edited.
23. ↑ "Noonan syndrome" , ghr.nlm.nih.gov , 2020-4-15, Retrieved 2020-4-24. Edited.
24. ↑ "Russell-Silver syndrome" , rarediseases.info.nih.gov , 2017-6-29, Retrieved 2020-4-24. Edited.
25. ↑ "Early or delayed puberty" , www.nhs.uk , 2019-3-11, Retrieved 2020-4-25. Edited.
26. ↑ "Early Puberty: Causes and Consequences" , www.webmd.com , 2019-6-25, Retrieved 2020-4-25. Edited.
27. ↑ Mitchell E. Geffner, "Idiopathic Short Stature" , www.magicfoundation.org , Retrieved 2020-4-25. Edited.