- Growth inhibition symptoms
- Growth inhibition reasons
- Treatment of the Growth inhibition
Growth inhibitions at children - a state heterogeneous. Many endocrine, somatic, genetic and chromosomal diseases are followed by a growth inhibition. Most often lag in growth is caused by constitutional features of growth and development of the child. The most important clinical problem of growth inhibitions at children is differential diagnosis of various options of a nanism for the purpose of definition of exact option of low-tallness, the forecast of diseases and, therefore, the choice of methods of therapy.
Growth inhibition symptoms:
The most common form of a growth inhibition at children (about 75%) is constitutional which is in turn divided into three types:
* constitutional low-tallness: parents of low growth - low growth have a child;
* the constitutional growth inhibition - till the puberty period the child grows slowly, and then sharply catches up with the peers;
* the mixed form - the most widespread.
Such growth disorder can be seen already at the child's birth - his body weight and growth will be slightly less norm. If the newborn of the average constitution has height of 51-55 cm and body weight of 3100-3500, then growth of such children makes 47-50 cm, and body weight - 2700-3000. It demonstrates that the constitutional factors influence growth of the child during the pre-natal period.
At the age of 1-3 years parents can notice that their child is much lower than the coevals. If parents have a concern on the fact that the child lags behind in growth, it is worth addressing the endocrinologist. It will define whether on the business it is pathology of growth and as far as it is serious. You should not expect until the child goes to school and "will be extended".
The constitutional forms of a growth inhibition seldom happen considerable. The more growth inhibition degree, the is more probable existence of endocrine or cerebral pathology. Such child should be hospitalized in endocrinological department for inspection. If timely not to see a doctor and not to begin treatment, compensate deficit of growth it can already not to be successful.
Growth inhibition reasons:
The growth inhibition can be caused by two essentially different problems. The first - when the child lags behind in growth owing to the available disease. Then treatment which, quite perhaps, will really allow it is necessary and grow up and to keep health. What of these factors influence growth? Infectious diseases, heart diseases, chronic diseases of bones etc. cause diverse disturbances in an organism and detain it growth.
Especially great influence is exerted by diseases of hemadens, such as a hypophysis, a thyroid gland, adrenal glands. For this reason lag in growth has to be the cause for the address to the endocrinologist. The heaviest disturbances of processes of growth are observed at pathology of endocrine system. It is known that practically all hormones directly or permissivno participate in growth processes.
Human height is programmed genetically. It is carried out at the expense of Somatotropinum. Somatotropic hormone (STG, Somatotropinum, соматропин, a growth hormone) - one of anterior pituitary hormones. On a structure is peptide hormone. A growth hormone it is called for the fact that at children and teenagers, and also young people with yet not closed regions of growth in bones it causes the expressed acceleration linear (in length) growth, generally due to growth of long tubular bones of extremities.
Secretion of Somatotropinum gradually goes down with age. It is minimum at elderly and old men, is maximum at teenagers in the period of the intensive linear growth and puberty. Adults have a pathological increase in level of Somatotropinum or long introduction of exogenous Somatotropinum in the doses characteristic of the growing organism, leads to a thickening of bones and a posterization of features, increase in the sizes of language - to a so-called akromegaloidny structure of a skeleton.
If secretion of this hormone stops ahead of time, then growth stops. It can be for various reasons: injuries. diseases, etc.
The growth inhibition (nanism) caused by deficit of somatotropic hormone - one of urgent problems of all society. The disease is shown in essential delay of physical development, as a result the children who are not receiving the corresponding treatment over the years cannot reach the usual average height of the adult and are doomed remain all life small, in fact - disabled people.
Treatment of the Growth inhibition:
Roststimuliruyushchy therapy is appointed.
For the purpose of treatment of a growth inhibition at gipotalamo-pituitary insufficiency of somatotropic hormone apply a human growth hormone in combination with thyroid drugs (with thyritropic insufficiency), anabolic steroids, gonadotropic and sex hormones (at loss of gonadotropic function).
The analysis of results of treatment showed that growth rates of patients with a cerebral and pituitary nanism, before treatment the making 1-3 cm a year, against the background of treatment by human Somatotropinum average 6,5 cm a year that does not contradict the data obtained by other researchers.
At treatment alternation by Somatotropinum with retabolil the annual increase in growth increases up to 8,6 cm, and at Somatotropinum combination to thyroid hormones and a chorionic gonadotrophin to 12 cm a year.
The best results were observed at children of younger age with low indicators of "bone age" by the time of the beginning of therapy.
Replacement adequate therapy is shown to patients with the growth inhibition caused by a hypothyroidism and a hypogonadism by the corresponding hormones.
Children and teenagers with constitutional low-tallness, a syndrome of a late puberty and family it is undersized an awn do not need roststimuliruyushchy treatment.
At patients with a syndrome Nunan and Shereshevsky-Turner roststimuliruyushchy treatment is inefficient.
1. The most common form of a growth inhibition at boys of a teenage vozrasg is constitutional nizk-tallness, a syndrome of a late puberty, girls have Shereshevsky-Turner's syndrome - the states which are not demanding roststimuliruyushchy therapy.
2. Not less than 38% of the patients suffering from low-tallness need roststimuliruyushchy treatment.
3. Therapy by drugs of a human growth hormone is shown only by a sick cerebral and pituitary nanism which frequency does not exceed 17,4% among all undersized.
4. For establishment of the diagnosis of a cerebral and pituitary nanism it is not enough to investigate the STG basal level. Conducting the functional load trials allowing to reveal reserve opportunities of gipotalamo-pituitary system is necessary.
5. As an optimum set of tests for definition of somatotropic and thyritropic reserves of gipotalamo-pituitary system serve tests with L-DOFA and tiroliberiny.