People can grow too fast

If children grow too much or too little - always have growth disorders checked by a doctor


Stunted growth from babies to teenagers is one of the most common reasons to see a pediatrician. In fact, around 3% of all children are short or tall. The causes of stunted growth are manifold. Often these are deviations from the norm that no longer require medical treatment. But they can also be the first sign of a serious illness.

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Therefore, they should always be clarified by the pediatrician and, if necessary, a pediatric endocrinologist. Too little, but also too early or too strong growth in length can be very stressful for those affected and their relatives. An adult height of less than 150cm is considered a disability in Germany. In fact, significantly fewer tall people than short people seek medical clarification. "This may be related to the fact that tall stature is much more socially accepted than short stature," says Professor Dr. med. Joachim Wölfle, President of the German Society for Child Endocrinology (DGKED) and chairman of the working group “Pediatric Endocrinology and Diabetology” of the DGE.
The fastest growth occurs in the mother's womb. Within nine months, the fertilized egg cell develops into a complete small human measuring 46 to 55 cm (3rd to 97th percentile) in girls and 47 to 55.5 cm (3rd to 97th percentile) in boys. "Never again does a person grow as quickly as in this time," explains the pediatric endocrinologist and director of the Clinic for Pediatric Medicine at the Erlangen Clinic of the Friedrich-Alexander University Erlangen-Nuremberg. Even in the first year of life, growth is still fast: on average, girls grow 24.5cm and boys 25.5cm (1). In childhood, the rate of growth gradually decreases - until the last growth spurt in puberty. Under the influence of the sex hormones there is an increased growth in length. As a rule of thumb, girls still grow about 4 to 5 cm after their first menstrual period. "Unfortunately there is no corresponding reference value for boys," says Professor Wölfle.

A deviation from the norm in height growth can also be based on a predisposition

A deviation from the norm does not automatically mean that the child is sick, reassures Professor Wölfle. Nevertheless, it is important to rule out organic diseases that can lead to growth disorders. Often it is only a matter of normal variations in size growth, for example as a result of family predisposition. Constitutional delays in growth and development usually require more attention. “Malnutrition or malnutrition, but also debilitating diseases such as severe asthma, cystic fibrosis or acquired severe heart diseases such as heart failure can lead to short stature. The hormone-related causes of short stature include, for example, an underactive thyroid, Cushing's syndrome, rickets, poorly controlled diabetes mellitus or a deficiency in growth hormone, ”explains Professor Dr. med. Matthias M. Weber, media spokesman for the DGE and head of the endocrinology and metabolic diseases department at the Mainz University Medical Center. Short stature can also be the first symptom of other serious illnesses. These include chronic kidney failure or achondroplasia - a rare hereditary disease in which the upper arm and thigh bones in particular are shortened. "The rapid progress in genetic diagnostics has made it possible to identify the causes of disease in the recent past and thus offers the possibility of developing more targeted therapies," reports Professor Wölfle.

Tall stature can also represent other concomitant diseases that are not visible at first glance. Patients with the so-called Marfan syndrome not only suffer from above-average growth in length. They are often associated with malformations of the cardiovascular system such as bulging of the aorta (so-called aneurysm) and tears and gaps between the vessel walls of the main artery (dissections). Unrecognized, they can lead to life-threatening complications.

(Medicine - Communication Medical Communication, Working Group of Scientific Medical Societies)
Source: idw, pediatrics up2date