Grow a person to dwarfism

Short stature

Short stature: Body length below the 3rd percentile of healthy children.

That is, 97% of children in their age group are taller. Usually the short stature is the result of a reduced growth rate or a shortened growth period; Only about 5% of small children have an underlying disease. In Germany, around 100,000 people are of short stature.

Leading complaints

  • Your child belongs to the smallest 3% of their age group.

When to the doctor

In the next few weeks if

  • Your child is unusually small, especially if there used to be no noticeable difference in size from their peers.

In the next few days if

  • You notice any other abnormalities in your very young child, such as unusually early puberty.

The illness

Size is relative, and so it is understandable that even doctors cannot always clearly say where exactly the limit is Short stature (also called short stature) lies.

How tall a person grows is largely hereditary. Doctors estimate the "target size" of a child according to the height of the parents: the height of the parents (in cm) is added, divided by two, and then 6 cm added (for boys) or subtracted (for girls). So small parents usually have small children, big parents have big children. This family-related short or tall stature is characterized by the fact that the child is one of the little ones or the bigger ones from kindergarten age at the latest, but its growth rate remains normal (i.e. it follows roughly the same corridor on the percentile curve).

Another growth variant has to do with body fat: Overweight children grow faster than their slim contemporaries, but the faster growth has no influence on their final height.

Constitutional Developmental Delay

The constitutional developmental delay is a hereditary variant of growth and with 27% the second most common cause of short stature.

Boys in particular are affected. These children enter puberty later than their peers, and since the growth spurt associated with puberty is a long time coming, they are very small compared to their peers for a period of time. But when puberty does come with these "late developers", they grow to about their "calculated" target size. This form occurs in families, which means that one or both parents were also delayed in their development as children.

Causes and Risk Factors

The primary short stature is not caused by disease, but by heredity. It is also called familial short stature and is the most common cause of short stature.

The secondary short stature is an impairment of growth as a consequence (secondary) of genetically determined acquired chronic, i. H. long-term diseases.

Most small children have no organic causes, usually a combination of family-related short stature and constitutionally retarded growth and development is the cause.

Genetic defects. Secondary short stature is often the result of pathologically altered hereditary dispositions such as in Down syndrome or in Ullrich-Turner syndrome, which only occurs in girls.

Skeletal malformations. Some skeletal malformations (skeletal dysplasias) are also associated with short stature.

Hormonal imbalances. In some cases, hormonal imbalances are also responsible for the reduced growth, the most common being a lack of growth hormone. Typically, with growth hormone deficiency, children grow less than 4 cm per year instead of the normal 5-7 cm. Many forms of growth hormone deficiency have no identifiable cause; other forms are congenital. A pituitary tumor is rarely responsible for the deficiency. An underactive thyroid or hyperaldosteronism (overactive adrenal cortex) are also among the causes of short stature.

Immunodeficiency. Inflammatory bowel disease such as ulcerative colitis or Crohn's disease can affect height growth.

Chronic illnesses such as heart, lung or intestinal diseases increase the risk of a child falling behind in growth.

Pregnancy. Former premature babies tend to grow at a slower rate. Likewise, child growth in all phases of pregnancy is influenced by various "sins" of the expectant mother: malnutrition or malnutrition, but above all, smoking is the main cause of small birth size. Alcohol and drug consumption or an infection during pregnancy also have a negative effect on placental blood flow and thus on the nutrition of the embryo.

Complications

Children who are too young are judged to be younger and treated accordingly. In addition, there are everyday problems for small children, for example when they find suitable clothes, sit on a chair at the table or want to open a door.

Diagnostic assurance

Bone age. Using an X-ray examination of the left hand, the doctor determines the maturity of the bone (the Bone age) of the child. The bone age roughly indicates the biological maturity of a child and thus allows conclusions to be drawn about the remaining growth potential. A bone age that is significantly reduced compared to the chronological (actual) age, for example, suggests that there is still considerable growth potential.

State of puberty development. Some growth disorders go hand in hand with a lack of or delayed puberty (such as Ullrich-Turner syndrome in girls or Klinefelter syndrome in boys), and on the other hand, prognoses for further growth can be derived from this. With the onset of the menstrual period, girls will have reached around 95% of their later adult size, which means that they will only grow around 8 cm afterwards (this, however, varies considerably depending on the age of the girl).

Hormone determinations. If hormonal disorders are suspected, the corresponding hormone concentrations in the blood are determined and additional hormonal tests may be carried out. A short hospital stay may be required for this.

treatment

Hereditary short stature can only be treated in a few forms. The earlier the growth disorder is recognized, the better a therapy will work.

Hormone therapy. If a child who is too young is deficient in hormones (growth or thyroid hormones), it is possible to administer the missing hormones in order to achieve a reasonably "normal" final height (hormone replacement therapy). Regular check-ups are essential so that the dose can be regularly adjusted to the physical changes in the child. Treatment with growth hormone is continued until the growth approximates that of the age group.

Orthopedic treatment. In rare cases, orthopedic interventions, through which the arm or leg bones are mechanically stretched, help. This lengthy treatment is very painful and very rarely used.

Your pharmacy recommends

What you can do as a parent

Improve self-confidence. If you accept your child for who they are and increase their confidence, they have the best chance of doing well in life.

Sports. Find the right sport for your child. In judo, for example, it is an advantage if the boy (or the girl) is smaller and therefore lighter.

Authors

Dr. med. Herbert Renz-Polster in: Gesundheit heute, edited by Dr. med. Arne Schäffler. Trias, Stuttgart, 3rd edition (2014). Revision and update of the sections "Description", "Symptoms and complaints", "When to see the pediatrician", "The disease", "Confirmation of diagnosis", "Treatment" and "Your pharmacy recommends": Dagmar Fernholz | last changed on at 10:27


Important note: This article has been written according to scientific standards and has been checked by medical professionals. The information communicated in this article can in no way replace professional advice in your pharmacy. The content cannot and must not be used to make independent diagnoses or to start therapy.