How do you know if a child has dwarfism

Dwarfism - Symptoms and causes

Overview

Dwarfism is short stature that results from a genetic or medical condition. Dwarfism is generally defined as an adult height of 4 feet 10 inches (147 centimeters) or less. The average adult height among people with dwarfism is 4 feet (122 cm).

Many different medical conditions cause dwarfism. In general, the disorders are divided into two broad categories:

Disproportionate dwarfism. If body size is disproportionate, some parts of the body are small, and others are of average size or above-average size. Disorders causing disproportionate dwarfism inhibit the development of bones.
Proportionate dwarfism. A body is proportionately small if all parts of the body are small to the same degree and appear to be proportioned like a body of average stature. Medical conditions present at birth or appearing in early childhood limit overall growth and development.

Some people prefer the term "short stature" or "little people" rather than "dwarf" or "dwarfism. " So it's important to be sensitive to the preference of someone who has this disorder. Short stature disorders do not include familial short stature — short height that's considered a normal variation with normal bone development.

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Symptoms

Signs and symptoms — other than short stature — vary considerably across the spectrum of disorders.

Disproportionate dwarfism

Most people with dwarfism have disorders that cause disproportionately short stature. Usually, this means that a person has an average-size trunk and very short limbs, but some people may have a very short trunk and shortened (but disproportionately large) limbs. In these disorders, the head is disproportionately large compared with the body.

Almost all people with disproportionate dwarfism have normal intellectual capacities. Rare exceptions are usually the result of a secondary factor, such as excess fluid around the brain (hydrocephalus).

The most common cause of dwarfism is a disorder called achondroplasia, which causes disproportionately short stature. This disorder usually results in the following:

An average-size trunk
Short arms and legs, with particularly short upper arms and upper legs
Short fingers, often with a wide separation between the middle and ring fingers
Limited mobility at the elbows
A disproportionately large head, with a prominent forehead and a flattened bridge of the nose
Progressive development of bowed legs
Progressive development of swayed lower back
An adult height around 4 feet (122 cm)

Another cause of disproportionate dwarfism is a rare disorder called spondyloepiphyseal dysplasia congenita (SEDC). Signs may include:

A very short trunk
A short neck
Shortened arms and legs
Average-size hands and feet
Broad, rounded chest
Slightly flattened cheekbones
Opening in the roof of the mouth (cleft palate)
Hip deformities that result in thighbones turning inward
A foot that's twisted or out of shape
Instability of the neck bones
Progressive hunching curvature of the upper spine
Progressive development of swayed lower back
Vision and hearing problems
Arthritis and problems with joint movement
Adult height ranging from 3 feet (91 cm) to just over 4 feet (122 cm)

Proportionate dwarfism

Proportionate dwarfism results from medical conditions present at birth or appearing in early childhood that limit overall growth and development. So the head, trunk and limbs are all small, but they're proportionate to each other. Because these disorders affect overall growth, many of them result in poor development of one or more body systems.

Growth hormone deficiency is a relatively common cause of proportionate dwarfism. It occurs when the pituitary gland fails to produce an adequate supply of growth hormone, which is essential for normal childhood growth. Signs include:

Height below the third percentile on standard pediatric growth charts
Growth rate slower than expected for age
Delayed or no sexual development during the teen years

When to see a doctor

Signs and symptoms of disproportionate dwarfism are often present at birth or in early infancy. Proportionate dwarfism may not be immediately apparent. See your child's doctor if you have any concerns about your child's growth or overall development.

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Causes

Most dwarfism-related conditions are genetic disorders, but the causes of some disorders are unknown. Most occurrences of dwarfism result from a random genetic mutation in either the father's sperm or the mother's egg rather than from either parent's complete genetic makeup.

Achondroplasia

About 80 percent of people with achondroplasia are born to parents of average height. A person with achondroplasia and with two average-size parents received one mutated copy of the gene associated with the disorder and one normal copy of the gene. A person with the disorder may pass along either a mutated or normal copy to his or her own children.

Turner syndrome

Turner syndrome, a condition that affects only girls and women, results when a sex chromosome (the X chromosome) is missing or partially missing. A female inherits an X chromosome from each parent. A girl with Turner syndrome has only one fully functioning copy of the female sex chromosome rather than two.

Growth hormone deficiency

The cause of growth hormone deficiency can sometimes be traced to a genetic mutation or injury, but for most people with the disorder, no cause can be identified.

Other causes

Other causes of dwarfism include other genetic disorders, deficiencies in other hormones or poor nutrition. Sometimes the cause is unknown.

Complications

Complications of dwarfism-related disorders can vary greatly, but some complications are common to a number of conditions.

Disproportionate dwarfism

The characteristic features of the skull, spine and limbs shared by most forms of disproportionate dwarfism result in some common problems:

Delays in motor skills development, such as sitting up, crawling and walking
Frequent ear infections and risk of hearing loss
Bowing of the legs
Difficulty breathing during sleep (sleep apnea)
Pressure on the spinal cord at the base of the skull
Excess fluid around the brain (hydrocephalus)
Crowded teeth
Progressive severe hunching or swaying of the back with back pain or problems breathing
Narrowing of the channel in the lower spine (spinal stenosis), resulting in pressure on the spinal cord and subsequent pain or numbness in the legs
Arthritis
Weight gain that can further complicate problems with joints and the spine and place pressure on nerves

Proportionate dwarfism

With proportionate dwarfism, problems in growth and development often result in complications with poorly developed organs. For example, heart problems that often occur with Turner syndrome can have a significant effect on health. An absence of sexual maturation associated with growth hormone deficiency or Turner syndrome affects both physical development and social functioning.

Pregnancy

Women with disproportionate dwarfism may develop respiratory problems during pregnancy. A C-section (cesarean delivery) is almost always necessary because the size and shape of the pelvis doesn't allow for successful vaginal delivery.

Public perceptions

Most people with dwarfism prefer not to be labeled by a condition. However, some people may refer to themselves as dwarfs, little people or people of short stature. The word "midget" is generally considered an offensive term.

People of average height may have misconceptions about people with dwarfism. And the portrayal of people with dwarfism in modern movies often includes stereotypes. Misconceptions can impact a person's self-esteem and limit opportunities for success in school or employment.

Children with dwarfism are particularly vulnerable to teasing and ridicule from classmates. Because dwarfism is relatively uncommon, children may feel isolated from their peers.

By Mayo Clinic Staff

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Dwarfism - Diagnosis and treatment

Diagnosis

Your pediatrician will likely examine a number of factors to assess your child's growth and determine whether he or she has a dwarfism-related disorder. In some cases, disproportionate dwarfism may be suspected during a prenatal ultrasound if very short limbs disproportionate to the trunk are noted.

Diagnostic tests may include:

Measurements. A regular part of a well-baby medical exam is the measurement of height, weight and head circumference. At each visit, your pediatrician will plot these measurements on a chart to show your child's current percentile ranking for each one. This is important for identifying abnormal growth, such as delayed growth or a disproportionately large head. If any trends in these charts are a concern, your pediatrician may make more-frequent measurements.
Appearance. Many distinct facial and skeletal features are associated with each of several dwarfism disorders. Your child's appearance also may help your pediatrician to make a diagnosis.
Imaging technology. Your doctor may order imaging studies, such as X-rays, because certain abnormalities of the skull and skeleton can indicate which disorder your child may have. Various imaging devices may also reveal delayed maturation of bones, as is the case in growth hormone deficiency. A magnetic resonance imaging (MRI) scan may reveal abnormalities of the pituitary gland or hypothalamus, both of which play a role in hormone function.
Genetic tests. Genetic tests are available for many of the known causal genes of dwarfism-related disorders, but these tests often aren't necessary to make an accurate diagnosis. Your doctor is likely to suggest a test only to distinguish among possible diagnoses when other evidence is unclear or as a part of further family planning. If your pediatrician believes your daughter may have Turner syndrome, then a special lab test may be done that assesses the X chromosomes extracted from blood cells.
Family history. Your pediatrician may take a history of stature in siblings, parents, grandparents or other relatives to help determine whether the average range of height in your family includes short stature.
Hormone tests. Your doctor may order tests that assess levels of growth hormone or other hormones that are critical for childhood growth and development.

Health care team

A number of disorders causing dwarfism can cause a variety of developmental problems and medical complications. Several specialists may be involved in screening for specific conditions, making diagnoses, recommending treatments and providing care. This team may evolve as your child's needs change, and your family doctor or pediatrician can coordinate the care.

Specialists in your care team may include:

Hormone disorder specialist (endocrinologist)
Ear, nose and throat (ENT) specialist
Specialist in skeletal disorders (orthopedist)
Specialist in genetic disorders (medical geneticist)
Heart specialist (cardiologist)
Eye specialist (ophthalmologist)
Mental health provider, such as a psychologist or psychiatrist
Nervous system abnormalities specialist (neurologist)
Dental specialist in correcting problems with teeth alignment (orthodontist)
Developmental therapist, who specializes in therapy to help your child develop age-appropriate behaviors, social skills and interpersonal skills
Occupational therapist, who specializes in therapy to develop everyday skills and to use adaptive products that help with everyday activities

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Genetic testing
MRI
X-ray

Treatment

The goal of treatment is to maximize functioning and independence. Most dwarfism treatments don't increase stature but may correct or relieve problems caused by complications.

Surgical treatments

Surgical procedures that may correct problems in people with disproportionate dwarfism include:

Correcting the direction in which bones are growing
Stabilizing and correcting the shape of the spine
Increasing the size of the opening in bones of the spine (vertebrae) to alleviate pressure on the spinal cord
Placing a shunt to remove excess fluid around the brain (hydrocephalus), if it occurs

Hormone therapy

For individuals with dwarfism due to growth hormone deficiency, treatment with injections of a synthetic version of the hormone may increase final height. In most cases, children receive daily injections for several years until they reach a maximum adult height — often within the average adult range for their family.

Treatment may continue throughout the teen years and early adulthood to ensure adult maturation, such as appropriate gain in muscle or fat. Some individuals may need lifelong therapy. The treatment may be supplemented with other related hormones if they are also deficient.

Treatment for girls with Turner syndrome also requires estrogen and related hormone therapy in order for them to begin puberty and achieve adult sexual development. Estrogen replacement therapy usually continues throughout life until women with Turner syndrome reach the average age of menopause.

Growth hormone supplementation for children with achondroplasia does not increase final adult height.

Ongoing health care

Regular checkups and ongoing care by a doctor familiar with dwarfism can improve quality of life. Because of the range of symptoms and complications, treatments are tailored to address problems as they occur, such as assessment and treatment for ear infections, spinal stenosis or sleep apnea.

Adults with dwarfism should continue to be monitored and treated for problems that occur throughout life.

Limb lengthening

Some people with dwarfism choose to undergo surgery called extended limb lengthening. This procedure is controversial for many people with dwarfism because, as with all surgeries, there are risks. Waiting to decide about limb lengthening until the person with dwarfism is old enough to participate in the decision is recommended because of the emotional and physical stress involved with multiple procedures.

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Lifestyle and home remedies

Talk with your pediatrician or a specialist about at-home care. Issues particularly critical for children with disproportionate dwarfism include:

Car seats. Use an infant car seat with firm back and neck supports. Continue using a car seat in the rear-facing direction to the highest weight and height possible (and beyond the recommended age limit).
Infant carriers and play equipment. Avoid infant devices — such as swings, umbrella strollers, carrying slings, jumper seats and backpack carriers — that don't support the neck or that curve the back into a C shape.
Adequate head and neck support. Support your child's head and neck when he or she is seated by holding the head, neck and upper back in a safe and stable position. Padding can help to provide the right position and support.
Complications. Monitor your child for signs of complications, such as ear infection or sleep apnea.
Posture. Promote good posture by providing a pillow for the lower back and a footstool when your child is sitting.
Healthy diet. Begin healthy-eating habits early to avoid later problems with weight gain.
Healthy activities. Encourage participation in appropriate recreational activities, such as swimming or bicycling, but avoid sports that involve collision or impact, such as football, diving or gymnastics.

Coping and support

If your child has dwarfism, you can take a number of steps to help him or her cope with challenges and function independently:

Seek help. The nonprofit organization Little People of America provides social support, information about disorders, advocacy opportunities and resources. Many people with dwarfism stay actively involved in this organization throughout their lives.
Modify your home. Make changes to your home, such as putting specially designed extensions on light switches, installing lower handrails in stairways and replacing doorknobs with levers. The Little People of America website provides links to companies that sell adaptive products, such as size-appropriate furniture and everyday household tools.
Provide personal adaptive tools. Everyday activities and self-care can be a problem with limited arm reach and problems with dexterity. The Little People of America website provides links to companies that sell adaptive personal products and clothing. An occupational therapist also may be able to recommend appropriate tools for home and school use.
Talk to educators. Talk to school personnel about what dwarfism is, how it affects your child, what needs your child may have in the classroom and how the school can help meet those needs.
Talk about teasing. Encourage your child to talk to you about his or her feelings, and practice responses to insensitive questions and teasing. If your child tells you that bullying occurs in school, seek help from your child's teacher, principal or the school guidance counselor and ask for a copy of the school's policy on bullying.

Preparing for your appointment

How you learn whether your child has dwarfism will depend on the degree to which it affects his or her development. Disproportionate dwarfism is usually apparent at birth or early in infancy. Proportionate dwarfism may not be diagnosed until later in childhood or the teenage years if your child isn't growing at an expected rate.

Well-baby visits and annual checkups

It's important to take your child to all regularly scheduled well-baby visits and annual appointments throughout childhood. These visits are an opportunity for your child's doctor to track growth, note delays in expected growth and identify other problems in physical development.

Questions your child's doctor may ask include:

What concerns do you have about your child's growth or development?
How well does he or she eat?
Is your child reaching certain milestones in development, such as rolling over, pushing up, sitting up, crawling, walking or speaking?
Are other members of the family very short, or have others experienced growth delays?
Do you have your child's height marked on a measuring chart that you brought with you?
Do you have photographs of your child at various ages that you brought with you?

Talking to your doctor about dwarfism

If your family doctor or pediatrician believes that your child exhibits signs of dwarfism, you may want to discuss these questions:

What diagnostic tests will be needed?
When will we learn the results of the tests?
What specialists will we need to see?
How will you screen for disorders or complications that are commonly associated with the type of dwarfism affecting my child?
How will you monitor my child's health and development?
Can you suggest educational materials and local support services for dwarfism?

Preparing and anticipating questions will help you make the most of your appointment time.

By Mayo Clinic Staff

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Dwarf, or short stature - the causes of appearance, in what diseases it occurs, diagnosis and methods of treatment

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Dwarf growth: causes of occurrence, in which diseases it occurs, diagnosis and methods of treatment.

Definition

Dwarfism (dwarfism, dwarfism, dwarfism) is considered to be a condition when the height of an adult male does not exceed 130 cm, and that of a female - 120 cm. Dwarfism is diagnosed when the stunting is more than 40%. If it does not exceed 20%, they speak of insufficient growth.

Varieties of dwarfism

Depending on the causes of growth retardation, several variants of dwarfism are distinguished. A significant part of the cases of dwarfism is due to growth retardation or cessation under the influence of toxic factors or nutritional deficiencies .

An important role is played by endocrine factors , first of all, low levels of growth hormone - somatotropin. With its lack or immunity to it, the body growth slows down. In addition, nanism can be observed with a deficiency of thyroid hormone (hypothyroidism) and sex hormones (hypogonadism).

Premature cessation of growth occurs with an excess of glucocorticoids - steroid hormones that are produced in the adrenal cortex.

Dwarfism as a result of genetic and chromosomal pathologies refers to hereditary factors of growth retardation with impaired intrauterine development.

In some cases, short stature may be due to systemic diseases .

Nanism can also be classified according to another feature - proportional and disproportionate physique .

Possible causes of dwarfism

Influence of exogenous factors . Growth retardation during fetal development can be caused by various chemical compounds, including drugs, drugs, as well as x-ray exposure and prolonged hypoxia.

The most critical in this respect are the first 3 months of pregnancy.

Hormonal imbalance . Premature cessation of growth due to endocrine disorders is one of the most severe malformations. Somatotropic hormone, or growth hormone, which is produced in the anterior pituitary gland, has a direct effect on growth.

Dwarfism can develop both due to somatotropic insufficiency, and due to the immunity of receptors of various tissues of the body to somatotropin.

Very often, growth hormone deficiency is combined with insufficient production of other hormones of the adenohypophysis, which causes the development of panhypopituitarism.

The disease develops for a very long time, and its first symptoms are growth retardation and a change in figure with the development of eunuchoid proportions (short torso and long limbs). Growth retardation becomes apparent only in the second year of a child's life, and after 4 years, the increase in height usually does not exceed 2–3 cm per year. A characteristic sign of the disease are small, doll-like facial features. There is atrophy of the gonads, a delay in the development of the genital organs.

Lack of function of the pituitary gland leads to disruption of the growth and function of other endocrine glands (thyroid, pancreas, genital).

In adult patients with congenital somatotropic insufficiency, in addition to growth retardation, there is obesity with an abdominal type of fat distribution, a decrease in muscle mass, hypotension, osteoporosis and early atherosclerosis, a decrease in body hair and atrophy of the external genital organs and mammary glands in women, a low level physical and intellectual activity.

Symptoms of the disease appear when no more than 10% of functioning pituitary cells remain.

With an isolated congenital decrease in the production of thyroid-stimulating hormones - hypothyroidism - growth retardation and disproportion of "bone" age are also observed. But unlike patients with somatotropic insufficiency, in children with hypothyroidism, body proportions are disturbed. Children with congenital hypothyroidism are overweight, have swelling of the face and limbs; in a hoarse voice. They have poor healing of the umbilical wound; prolonged, more than a week, jaundice. In the absence of timely treatment, other typical signs appear: lethargy, decreased appetite and worsening of the sucking reflex, difficulty in swallowing, flatulence and constipation; dry and flaky skin; cold hands and feet; brittle, dull hair. With age, growth retardation and a lag in psychomotor development appear.

The intellectual development of the child suffers the more, the later treatment is started.

Malformations of "bone" growth consist in the lag in the development of the facial skeleton, late eruption and change of teeth.

With a decrease in the production of sex hormones - hypogonadism - in addition to growth retardation, there is an underdevelopment of the genital organs, sometimes obesity. Congenital forms of hypogonadism are very often combined with a deficiency of other pituitary hormones and syndromic pathologies, including Prader-Willi, Bardet-Biedl, Lawrence-Moon, Rod, and Madoc syndromes.

Hereditary diseases of the musculoskeletal system . Small growth may be due to achondroplasia, or chondrodysplasia, which is hereditary. The disease is accompanied by a slowdown in bone growth and the growth of cells of the cartilage tissue of the epiphyses. The bones of the limbs become disproportionately short and thickened, the hands have the shape of a trident. There is macrocephaly with a protruding forehead and a flat bridge of the nose. At birth, growth may be within the lower limit of normal, but with age it is delayed. The intellect of patients is usually preserved, but motor development is delayed.

Osteopsatiros is also one of the hereditary diseases of the skeletal system. Violation of collagen synthesis leads to early ossification of the skeleton and, as a result, to the cessation of growth. In severe cases, neonatal death is possible. There may be significant bone defects in the temporal and occipital region.

One of the leading symptoms of the disease is a tendency to bone fractures, which can occur both during fetal development, and during and after childbirth.

Heart defects . Dwarfism can develop in children with serious congenital heart defects.

Chronic kidney disease . Chronic renal failure is almost always accompanied by growth retardation. Growth retardation is especially noticeable in the first two years of life and in puberty. In addition, glucocorticosteroids, which in some cases the patient is forced to take, also cause dysplasia.

Syndromic dwarfism . Dwarfism is inherent in patients with congenital genetically determined syndromes. These include Shereshevsky-Turner syndromes (gonadal dysgenesis), Nonne, Getchinson-Gilford, Russell-Silver, Seckel, Prader-Willi, Lawrence-Moon-Barde-Beadle.

All syndromal diseases are characterized by genetically determined intrauterine developmental disorders, which leads to numerous pathologies already at birth.

Which doctors to contact

Growth disorders and body imbalances are noted already in the first years of a child's life, and the primary diagnosis is made by a pediatrician. In the future, the help of an endocrinologist, orthopedist, urologist, nephrologist or cardiologist may be required.

Diagnosis and examination of dwarfism

Diagnosis begins with a survey and assessment of the height of the patient's parents. Anthropometric measurements (height, weight, etc.) are carried out and sexual development is assessed. The bone age of the child is determined using radiography.

X-ray of the skull

X-ray examination of the skull to detect violations of the structure and integrity of the bones of the skull of various nature.

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Examine the hormonal background: ACTH, growth hormone, insulin-like growth factor 1 (IGF-1), thyroid hormones (T3, T4) and TSH, gonadotropins (luteinizing hormone, follicle-stimulating hormone), testosterone.

ACTH

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Growth hormone (GH)

Synonyms: Blood test for growth hormone; Growth hormone analysis. Human Growth Hormone; HGH; somatotropin. Brief description of the analyzed analyte Somatotropic hormone Somatotropic g...

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Somatomedin-C (Insulin-like growth factor I, IGF-1; Insulin-like growth factor I, IGF-1)

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Free Triiodothyronine (Free T3, Free Triiodthyronine, FT3)

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Free thyroxine (T4 free, Free Thyroxine, FT4)

Free thyroxine, not bound to plasma transport proteins. Synonyms: Blood test for free thyroxine. Free T4; Free Form of Thyroxin. Short description ...

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Thyroid Stimulating Hormone (TSH)

A pituitary hormone that regulates thyroid function. One of the most important tests in the laboratory diagnosis of thyroid diseases. Synonym...

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Luteinizing Hormone (LH)

Synonyms: Glycoprotein gonadotropic hormone; luteotropin; Lutropin. luteinizing hormone; LH; Lutropin; Interstitial cell stimulating hormone; ICSH. Brief characteristic determined ...

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Follicle Stimulating Hormone (FSH)

Synonyms: Blood test for FSH; Follitropin. Follicle-Stimulating Hormone; follitropin; FSH. Brief description of the analyte Follicle-stimulating hormone ...

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Testosterone

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If growth hormone deficiency is detected, your doctor may recommend magnetic resonance imaging of the brain and molecular genetic testing.

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What to do about dwarfism

The first signs of growth retardation are noted, as a rule, from the first year of life.

It is necessary to undergo scheduled medical examinations of children under one year old (at 1, 3, 6, 9and 12 months), during which the doctor takes into account the weight, height, head and chest volume of the child.

Treatment of dwarfism

Treatment of patients with dwarfism depends on the nature of its occurrence. With dwarfism due to insufficient production of hormones, in the absence of a tumor process, replacement therapy is carried out. In severe chronic diseases of the heart and kidneys, treatment of the underlying diseases is necessary.

Sources:

Federal clinical guidelines (protocols) for the management of children with endocrine diseases / Ed. I.I. Dedova and V.A. Peterkova. – M.: Practice, 2014. – 442 p.
Bolshova-Zubkovskaya E.V., Tronko N.D. Pathology of growth and sexual development in children and adolescents. K.: Summit.kniga, 2003. - 94 p.
Filina N. Yu., Bolotova N.V., Nazarenko K.A. Modern diagnostics of short stature in children // Treating doctor. - No. 11, 2016. - P. 74.

IMPORTANT!

The information in this section should not be used for self-diagnosis or self-treatment. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For diagnosis and proper treatment, you should contact your doctor.
For a correct assessment of the results of your analyzes in dynamics, it is preferable to do studies in the same laboratory, since different laboratories may use different research methods and units of measurement to perform the same analyzes.

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Stunting (Dwarfism): Symptoms, Causes, Treatment | doc.

Short stature (Dwarfism, Pituitary dwarfism) is a syndrome that is caused by both endocrine and non-endocrine diseases. This disease is very rare and is characterized by a delay in physical development and growth characteristics, which is associated with problems in the secretion of somatotropin (growth hormone). Nanism is translated from Greek as "dwarf".

Attention!

Here you can choose a doctor who specializes in the treatment of Stunting (Dwarfism) If you are not sure about the diagnosis, make an appointment with a general practitioner or general practitioner to clarify the diagnosis.

Symptoms

A sign of dwarfism is considered to be less than 130 cm for a man and less than 120 cm for a woman. In children who are practically healthy, family short stature can be perceived as a variant of physical development.

A strong lag in growth and development relative to the average norms for a certain age is characteristic, and this may be a decrease in the level of growth dynamics and body weight. From birth, such children may have quite normal indicators, but subsequently they may clearly lag behind their peers. In some forms, dwarfism in children can be noticed in the first year of life, but most often it is noticed from 2–4 years of age.

Those suffering from dwarfism have more child-like proportions. The skin may be pale, dry, which is determined by the complete or partial insufficiency of the functions of the parathyroid glands. For those who have not received proper treatment, the skin may begin to age early, wrinkles will appear. Adipose tissue is also poorly developed; excess fat deposits on the chest, hips, and abdomen can be diagnosed. The muscular system is also poorly developed. Often there is no secondary hair growth. Also an essential feature is the slow ossification of the skeleton. It is possible to note the late replacement of milk teeth with molars.

Loss of the gonadotropic function of the pituitary gland may be manifested by symptoms of insufficient sexual development. Males suffering from dwarfism usually have small penis sizes, an underdeveloped scrotum, and the absence of secondary sexual characteristics. Mental development may be normal with certain juvenile features. In the case of a neurological examination, signs of an organic lesion of the nervous system can be determined. Also, the size of internal organs often decreases, hypotension, bradycardia appear. Secondary hypocorticism may occur.

Internal organs are reduced in size. Often, with such a problem as dwarfism, the symptoms are muffled heart tones, arterial hypotension, and functional noises in different areas.

Causes

Among the causes of the development of such a disease as pituitary dwarfism, there is damage to the pituitary gland (various injuries, tumors, infectious and toxic damage), as well as dysregulation of the function of the pituitary gland relative to the hypothalamus.

Some genetic factors, traumatic, tumor, toxic and infectious problems of the intermediate pituitary zone play a role.

Reduction or complete loss of the somatotropic function of the pituitary gland, biologically inactive growth hormones or impaired sensitivity of peripheral tissues to it.

Many forms of pituitary dwarfism are genetic diseases. The most common is dwarfism. You can meet patients in whom the central nervous system is affected due to lack of oxygen and injuries. Often this occurs in the case of multiple pregnancies. Factors that exacerbate physical developmental disorders may be malnutrition, defective food, negative environmental factors.

Diagnosis

Slow growth and obvious short stature is determined already in the first months of a child's life, and somewhat less often - during puberty. As a result of x-ray examination, one can notice a delay in ossification and differentiation of the skeleton. Also, the basal concentration of growth hormone in the blood serum may be reduced or meet the norm; with the introduction of arginine or insulin, there is no increase in the secretion of growth hormone, as is the case with the norm. Sometimes there is even a short-term and barely noticeable increase in the level of its secretion.

Treatment

The essence of the treatment of dwarfism is hormone replacement therapy. Sometimes it is necessary to take sex and thyroid hormones. It is also necessary to cure the underlying disease that caused dwarfism.

The main method of pathogenetic treatment of dwarfism is the removal of human somatotropin. A very important way is the use of anabolic steroids.

Patients who have clinical manifestations of hypothyroidism should take thyroid hormone preparations. In order to stimulate sexual development after the growth zones are closed, sex hormones are used: for men - chorionic gonadotropin and preparations containing testosterone, and in the case of the pituitary adrenal cortex - glucocorticoids, for women these are estrogens, as well as preparations of the female body.

In the event that the functions of the central nervous system are impaired, vascular agents are prescribed.

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