Growth Hormone Treatment for Short Stature in Children

As parents, we often want our children to grow taller but worry about their short stature. Short stature usually refers to a child whose height is much lower than the average height for his or her age.

Short stature, growth hormone treatment in children

As parents, we often want our children to grow taller but worry about their short stature. Short stature generally refers to a child who is well below the average height for his or her age, meaning that the height is below the 3/5th percentile for children of the same age and sex. Normally, children grow very quickly during the first two years of life. Their growth then slows until they reach puberty, when height increases rapidly again. The final height is reached when the growth plates within the bone fuse, which is about 14 years of age in girls and 16 years of age in boys. If parents are concerned about their child's short stature, they should seek evaluation and diagnosis by a pediatric endocrinologist or pediatrician as soon as possible to avoid missing a golden opportunity for treatment.

Short stature Growth hormone

There are many reasons for short stature, including

Heredity
Constitutional delay in growth and puberty
Unexplained short stature
Born small for gestational age with no catch-up growth
Endocrine problems such as growth hormone deficiency, hypothyroidism, and Cushing's syndrome
Skeletal dysplasia
Metabolic bone diseases, such as rickets and osteogenesis imperfecta (brittle bone disease)
Chronic disease, which is caused by insufficient nutritional intake, increased energy requirements, inflammatory cytokines and steroid use
How do chromosomal disorders such as Turner syndrome, Russell-Silver syndrome, and Prader-Willi syndrome determine the cause of short stature?

The doctor will evaluate the child based on medical records and a physical exam. Weight and height will be measured and plotted on a growth chart. The child's height will also be compared to the parent's height. Doctors need to review previous growth records to determine growth rate. Blood and X-ray tests will be done if needed to determine the cause of the short stature. Children suspected of having growth hormone deficiency may need a growth hormone stimulation test as a diagnosis. Any child diagnosed with growth hormone deficiency should have magnetic resonance imaging (MRI) of the brain and pituitary gland to determine the cause.

What are the red flags of being short?

Short stature is particularly concerning if:

Severely short, well below the 3rd percentile
Target height range beyond parental height estimate
Born small for gestational age and no catch-up growth after two years of age
Slow growth in height above 2 major percentiles
Signs and symptoms of chronic disease
Skeletal abnormalities
Abnormal facial features

Is there any treatment for short stature?

Treatment will depend on the underlying cause of short stature, and thyroid hormone replacement therapy may be used to treat hypothyroidism. Growth hormone can be used in cases of growth hormone deficiency, unexplained short stature, short stature caused by birth small for gestational age without catch-up growth, Turner syndrome, Prader-Willi syndrome, SHOX gene defects, and chronic renal failure. Growth hormone treatment requires daily subcutaneous injections at bedtime, but the injection process is simple. Growth hormone in the body stimulates growth and cell reproduction, promoting height growth. Children with unexplained short stature who receive growth hormone treatment may grow an additional 4 to 10 centimeters over a few years. But every child's response to growth hormone is different. Generally speaking, the earlier treatment is started, the better the response will be, and the final height will be more ideal.

What are the side effects of growth hormone treatment?

Growth hormone treatment is relatively safe and side effects are uncommon. However, if your child has headaches, hip pain, or abnormal gait when walking after receiving growth hormone treatment, you should talk to your doctor about possible adverse effects of the treatment. Rarely, benign intracranial hypertension (pseudotumor cerebri), slipped epiphysis of the femoral head, and worsening of existing scoliosis may occur. Common side effects include edema, local injection reactions, and joint and muscle pain. Your doctor will also monitor your child's insulin growth factor (IGF-1) levels, fasting blood sugar, glycated hemoglobin (HbA1c), thyroid function, and blood pressure.