Short Stature its causes and charactrastic feature of its type

Short Stature

Def: The height is significantly below the average range of other people in the same age group.

height is influenced by culture, gender and family history.

—           
Bone age: is determined by comparing the appearance and stage of ephiphyseal fusion or shapes of bones on the patient's radiograph with an atlas demonestrating normal skeletal maturation for various ages.

—            Non endocrinal causes of short stature


1- Constitutional short stature: constitutional delay in growth and adolescence (variation of normal) associated with retardation of bone age. The family history is usually present. These show normal birth height. The adult height is in the normal range

2-Genetic short stature: adult height depends on parent's height.

—             

—            3- Prematurity and intrauterine growth retardation present in 30% of IUGR caused by:

—             infections as toxoplasmosis,rubella,cytomegalo virus..Etc

—            maternal drug abuse (alcohols,phenytoin).

4-Syndromes of short stature:

—            a)Turner's syndrome:45,xo(diagnosed by karyotyping).

—             

—            b) Noonan’s syndrome :( pseudo-turner's) Karyotyping is 46, xx in females 46, xy in males. It is an autosomal dominant disorder at gene locus 12q 24.—            

—            c)Prader-willi syndrome: poor intrauterine movements, infantile hypotonia, small hands and feet. Developmental delay and extreme obesity. Glucose intolerance and delayed puberty.

—             

—            d)laurance moon and Biedl-Bradet syndrome: developmental delay,retititis pigementosa, polydactyly and obesity. In laurance-moon spastic paraplegia is also present. They are autosomal recessive disorders



Chromosomal disorders: major physical abnormalities and unusual body proportions.

—             

—            a)Down's syndromes or trisomy 21.

—             

—            b)autosomal dominant achondroplasia:

—            short extremities in the proximal regions ,relative large head , frontal bossing and depressed nasal bridge ,normal intellgence ,short stature

5-Chronic diseases: major organ failure

—            .Coeliac diseases.

—            Malabsorption.

—            Chronic infections

—            Hemolytic anemias

—            Juvenile RA

—            Renal tubular acidosis

—           
 6-malnutrition:

—            parasitic infections

—            Iron,zinc deficiency.

—             

—            7-medications: steroids,dextroamphetaine(hyperactivity).

—