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Pediatric Endocrinology (Expert Forum)
Bone growth 2-3 years behind
Answered by
Deanna L Aftab Guy, MD - Short Stature, thyroid, Pituitary abnormalit, Puberty concerns, Rapid Growth, Adrenal problems, Parathyroid abnormal, Rickets and bone dis
Vanderbilt Children’s Hospital
Nashville - TN
Questions in the Pediatric Endocrinology forum are answered by Dr. Deanna L Aftab Guy, affiliated with Vanderbilt Children's Hospital. Topics covered include adrenal problems, diabetes insipidus, menstrual irregularities, obesity, parathyroid abnormalities, pituitary abnormalities, puberty concerns, rapid growth, rickets and bone disease, short stature, and thyroid.
Bone growth 2-3 years behind
by KathijoG, May 23, 2008 04:40PM
My son had xrays of his hands done because the doctor was concerned about his height being so short. In the first year, he went from being born at 22.5 inches to 3rd percentile. I think it was around 9 months when he dropped down to the 3rd percentile and has always been riding that curve. The xrays had him at 5-6 years bone age and his age is almost 8. He wants us to see a Pediatric Endocrinologist. Is there any treatment that will allow him to grow to average height? I was just carious what a doctor can actually do to help someone who is short. My son is very sweet and emotional and gets bullied from the bigger kids at school. What is really weird is that my family carries a precocious puberty gene that makes them grow really fast but then the bone age caps out and they end up being really short. The women are carriers and the boys get it. I am a carrier but had the cord blood tested and my son doesn't have it. It seems he has the opposite problem. My cousin's daughter is very short. She is done growing now and is 4'9". They told them she had low hormone. She had short family members on both sides. She did not get any treatment. That is what I wanted to know. What kind of treatments are there for this.
Thanks for any help you can give. I hate to put him through all these tests if they can't do anything about it. I would love it they could speed up his growth as it has affected him socially.
Kathi
Thanks for any help you can give. I hate to put him through all these tests if they can't do anything about it. I would love it they could speed up his growth as it has affected him socially.
Kathi
Doctor's Answer
by Deanna L Aftab Guy, MD, May 24, 2008 11:33PM
, May 24, 2008 11:33PM
To: KathijoG
Delayed bone age is a good thing, it means that we have time to figure out whether this is due to some kind of hormone deficiency that needs replaced or perhaps that he is a late bloomer meaning he will catch up after his friends are done growing. What we don't want is for puberty to come on time and advance his bones too quickly and not allow him to reach his genetic potential.
So treatment depends on the test results, let the ped endo see him and do a complete history and physical, and screening labs and their own bone age and read it themselves. Then they will more than likely see him every 4-6 months to establish a growth velocity or proceed a little sooner with a gh stim test which is a test used to see how much gh the body makes in response to certain medications used that "coax" the growth hormone to be secreted, if he fails his gh stim test then he is gh deficienct, if he passes he may still very well need treatment but can be monitored a little longer depending how far off the curve he is.
Those that pass their test but really don't grow normally and everything else has been ruled out may indeed have idiopathic short stature.
Those with ISS growth beautifully on growth hormone as well as other products that we tend to use.
So I would definitely see the peds endo, sit down with them and yes, there is plenty they can do-remember we cannot make someone taller than they were meant to be-if we replace gh or give a growth promoting agent it is with the intent on getting them to their genetic potential since their present status can't do it without treatment!
So treatment depends on the test results, let the ped endo see him and do a complete history and physical, and screening labs and their own bone age and read it themselves. Then they will more than likely see him every 4-6 months to establish a growth velocity or proceed a little sooner with a gh stim test which is a test used to see how much gh the body makes in response to certain medications used that "coax" the growth hormone to be secreted, if he fails his gh stim test then he is gh deficienct, if he passes he may still very well need treatment but can be monitored a little longer depending how far off the curve he is.
Those that pass their test but really don't grow normally and everything else has been ruled out may indeed have idiopathic short stature.
Those with ISS growth beautifully on growth hormone as well as other products that we tend to use.
So I would definitely see the peds endo, sit down with them and yes, there is plenty they can do-remember we cannot make someone taller than they were meant to be-if we replace gh or give a growth promoting agent it is with the intent on getting them to their genetic potential since their present status can't do it without treatment!
