Parent Requests Growth Hormone for Child with Idiopathic Short Stature
| Autor: | Brian Stabler, Martin T. Stein, S. Douglas Frasier |
|---|---|
| Rok vydání: | 2004 |
| Předmět: |
Counseling
Male Parents Pediatrics medicine.medical_specialty Adolescent Dwarfism Short stature Developmental psychology Growth hormone deficiency Developmental and Educational Psychology medicine Humans Toddler Physician's Role Referral and Consultation Patient Care Team business.industry Human Growth Hormone Bone age Grandparent medicine.disease Combined Modality Therapy Body Height Recombinant Proteins Self Concept Pubic hair Idiopathic short stature Psychiatry and Mental health medicine.anatomical_structure El Niño Developmental Milestone Pediatrics Perinatology and Child Health medicine.symptom business Psychology Social Adjustment |
| Zdroj: | Journal of Developmental & Behavioral Pediatrics. 25:S79-S83 |
| ISSN: | 0196-206X |
| DOI: | 10.1097/00004703-200410001-00016 |
| Popis: | CASE. Cody was always a short child with stature at the fifth percentile of a standard growth curve since he was a toddler. His weight was between the 10th and 25th percentiles. Developmental milestones and early learning achievement were normal. He played in a youth soccer league from 8 to 10 years of age, but he was not enthusiastic about group sports. In middle school, Cody excelled in the sciences and enjoyed tennis and swimming with his friends. In the seventh and eighth grades, his parents reported that Cody was teased frequently about his short stature. When the pediatrician asked Cody about the teasing he was evasive. Cody's parents were concerned that experiencing adolescence as the shortest boy in the class would have a lasting negative effect on his self-esteem. His father, remembering his own painful childhood as a short boy who was bullied frequently by other children until late adolescence, read about growth hormone on the Internet and thought that it might help his son. Cody's father was 5'5 and his mother was 5'2. His father recalled initiating puberty later than his friends. The paternal grandparents were also short (5'2 and 4'8). At the 14-year-old health supervision visit, Cody's height was now below the 5th percentile. Review of systems was negative, and he continued to do well in school. Genitalia showed 2,5 cm testes with minimal scrotal thinning, Tanner 2 pubic hair, and no enlargement of the phallus. The thyroid gland was not enlarged; blood pressure and neurological examinations were normal. A bone age was 12 years 6 months (chronological age 14.0 years). The pediatrician ordered a complete blood count, erythrocyte sedimentation rate, chemistry panel, serum thyroxine, thyroid-stimulating hormone, insulin-like growth factor-1 (IGF-1), and IGF-binding protein-3 (IGFBP-3). All studies were normal for age. It was concluded that Cody had constitutional delay of growth and familial short stature. His parents asked if Cody could be given growth hormone to accelerate his growth during adolescence. The pediatrician found it difficult to engage Cody in a discussion about perceptions and feelings with regard to his growth. Without objective evidence of growth hormone deficiency, the pediatrician considered the physiological and psychological risks, potential benefits, and cost of treatment with growth hormone. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|