Diagnosis of high growth
At the beginning, the diagnosis focuses primarily on the exact anamnesis. The height of the parents and other close relatives will be inquired. In addition, it is important for the doctor to find out whether there are any other symptoms (as described above) that indicate a syndrome, a hormonal disorder or a chromosomal aberration.
The exact determination of body size, as well as the relationship of the individual skeletal parts to each other can provide further information about the possible causes. In addition, the percentile curve of the length development should be followed, since the course of the disease can give an indication of certain diseases. Further steps include an x-ray of the left hand to determine the child’s bone age, as well as an examination of the blood for growth and sex hormones. Furthermore, a chromosome analysis can also be performed if an aberration of the chromosome number is suspected.
Hormone therapy
Hormone therapy can be used in children or adolescents if prognostic calculations of the expected height result in values that are over 185cm for girls and over 200cm for boys. In girls estrogens are given alone or in combination with gestagens and in boys testosterone. The aim of this hormone therapy is to cause the growth joints in the bones, the epiphysis joints, to ossify prematurely and to stop the longitudinal growth of the bones.
The hormones simulate a condition that would otherwise only occur when girls and boys have come out of puberty and are already young adults. Due to its side effects, hormone therapy is very controversial among medical professionals. In girls, the hormones can cause changes in menstruation, weight gain, nausea, general malaise, changes in the breasts, nipples and external genitals.
In boys, weight gain, joint pain, severe acne, water retention and, as in girls, changes in the external genitals may occur. The duration of the treatment depends on the extent of the calculated growth, the age of the child, and the annual increase in length. The therapy can be extended over 1 – 2 years.
The therapy is terminated when the growth gaps are closed and accordingly no further growth can take place. In girls, a daily administration of an estrogen and a cycle-dependent administration of progesterone is given for 10-14 days. In boys, the therapy is administered by injecting a depot testosterone into a muscle (thigh, upper arm) every 14 days. It is essential to consult an endocrinologist for advice.
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