Growth disorders

Clinical information

There are many different reasons for growth disorders in infants, children and adolescents. Around 3% of children show too little, too early or too much length growth and are considered auxologically conspicuous. In many cases, these are but deviations from the norm that require no treatment. However, growth disorders can also be a first sign of underlying chronic illnesses. As these do require treatment, they must be excluded in differential diagnostics.

Diagnostics

Growth disorders can have a genetic or environmental cause or be a consequence of chronic diseases such as Crohn’s or coeliac disease. In rare cases, psychosocial or diet-related causes or hormone disorders are responsible for growth disorders. Finding the underlying cause is therefore the primary focus of growth disorder diagnostics.

The growth hormone (GH) of the pituitary gland and thyroid hormones are crucial for the regulation of growth. In the case of hormonal short stature, one or several of the hormones necessary for growth are not or insufficiently produced. This deficiency can have a congenital cause or one acquired during childhood. In contrast to other forms of short stature, growth hormone deficiency is treatable.

Endocrine-related tall stature is caused by hypersecretion of insulin-like growth factor I (IGF-I). In children and adolescents this hormone excess often causes changes of appearance, manifesting as excessively tall stature (so-called gigantism), while in adults it often leads to growth of certain parts of the body, so-called acromegaly. The IGF-I concentration can be determined to diagnose growth disorders more rapidly and to monitor growth hormone treatment.

In infants and young toddlers measurement of insulin-like growth factor binding protein-3 (IGFBP-3) is preferable to measurement of IGF-I.

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Growth