Definition
A growth disorder is the phenomenon that the size, length or shape of a certain part of the body or the entire body deviates from the norm either by excessive or reduced growth. Growth disturbances are often understood to be mainly length growth, i.e. a deviation in the height of the affected person. A distinction is made between short growth and tall growth. Furthermore, a distinction is made between primary (=inherited) growth disorders and secondary (=acquired) growth disorders:
- Congenital growth disorders often involve a defect in the genetic material that causes excessive or reduced growth.
- Acquired growth disorders can have many causes and can occur for the first time from infancy to teenage years. The affected patients are therefore mostly children and adolescents.
Causes
Congenital growth disorders often manifest themselves at birth through low birth weight and reduced body length and can thus already be detected by ultrasound examinations before birth. In other cases, the child has a normal birth weight and does not increase accordingly in the newborn and infant age. One possible cause of this is chromosomal anomalies, where the number or structure of the chromosomes (normal 46, XX in women or 46, XY in men) is altered, which manifests itself in a variety of symptoms and physical abnormalities.
For example, Down’s syndrome (trisomy 21) or Turner’s syndrome (women with only one X chromosome) are associated with reduced height. Other genetic defects (e.g. osteogenesis imperfecta, the brittle bone disease) are also associated with a reduced height. Furthermore, hormonal imbalances can lead to growth disorders.
This can have congenital or acquired causes, a well-known example is hypothyroidism. Intestinal diseases such as celiac disease can lead to growth disturbances due to malnutrition, as well as malnutrition due to insufficient food intake. Finally, certain forms of medical treatment, especially chemotherapeutic agents for cancer, long-term cortisone intake or radiation therapy can also lead to growth disorders.
To be distinguished from a growth disorder are phases in which children grow stronger than usual, but they are completely normal. You can find more information on this topic under: Growth spurt cortisone is a hormone produced naturally in the body, which means that the human body itself permanently produces small doses. In the body it fulfils numerous important functions, which primarily serve to inhibit inflammation.
As a drug, cortisone is often used in children as a spray or tablet in the therapy of bronchial asthma. Cortisone in ointment form is also used for numerous skin diseases such as neurodermatitis. The decisive factor for the occurrence of side effects is the amount of cortisone that is absorbed in the form of tablets via the intestines or as a spray via the lungs or as an ointment via the skin and enters the body’s circulation.
Here it can suppress the production of the body’s own growth hormones, among other things, by means of complicated control circuits (based on the principle of negative feedback). This results in reduced growth, but this only occurs during long-term therapy with high doses of cortisone. For this reason the physician should always critically review the cortisone dose and select the lowest possible dose.
With fractures in childhood, there is always the risk of growth disorders due to faulty healing. Depending on the type and location of the fracture, either excessive or reduced growth of the healing bone is possible. In particular, shaft fractures (in the middle part of long tubular bones of arms and legs) or epiphyseal fractures (fractures in the area of the growth plate, usually in joint fractures) carry an increased risk of subsequent growth disturbance.
If only one extremity is affected, two legs and arms of different lengths can result. Especially in the area of the legs, this can lead in the long term to premature joint wear (arthrosis) and the necessity to wear special orthopedic shoes with heels. For this reason, bone fractures in children should always be adequately treated and healing should be monitored.
All articles in this series:
