Mariani A, Chalies S, Jeandel C, Rodière M
Service de pédiatrie 1, CHU Arnaud-de-Villeneuve, 371, avenue du Doyen-Gaston-Giraud, 34295 Montpellier cedex 5, France.
Arch Pediatr. 2010 May;17(5):486-90. doi: 10.1016/j.arcped.2010.02.006. Epub 2010 Mar 24.
Psychosocial dwarfism is a rare condition, but can still be observed. We report the case of a 5-year-old girl seen in our clinic for severe growth retardation that had been evolving for several years. A growth arrest was observed beginning at the age of 3.5years. Initial clinical examination and biological investigations were negative. As the child was hospitalized, serious disturbances in mother-child relations were observed. A significant modification of the child's behavior was observed when the mother was absent. Following questioning, the mother admitted social problems; the pregnancy had not been desired and this contributed to a lack of attachment between the mother and the child. Psychosocial dwarfism seems to originate from serious disturbances in the mother-child relationship. It seems to be caused by a partial growth hormone deficiency and a frequent context of malnutrition due to food behavior disorders. Family problems need to be taken into account and intensive medical and psychological follow-up is required. Prognosis is good if an early diagnosis is made and followed with a close and prolonged follow-up.
心理社会型侏儒症是一种罕见的病症，但仍可被观察到。我们报告了一例5岁女童的病例，该女童因严重生长发育迟缓前来我们诊所就诊，这种迟缓已经持续数年。观察到生长停滞始于3.5岁。最初的临床检查和生物学检查均为阴性。当孩子住院时，观察到母子关系存在严重紊乱。母亲不在场时，孩子的行为有显著改变。经询问，母亲承认存在社会问题；此次怀孕并非她所期望的，这导致了母亲与孩子之间缺乏情感联结。心理社会型侏儒症似乎源于母子关系的严重紊乱。它似乎是由部分生长激素缺乏以及因饮食行为障碍导致的频繁营养不良状况所引起的。需要考虑家庭问题，并且需要进行强化的医学和心理随访。如果能早期诊断并进行密切且长期的随访，预后良好。
