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儿童和青少年身材矮小的病因:埃及一家三级护理医院的经验。

Etiological factors of short stature in children and adolescents: experience at a tertiary care hospital in Egypt.

作者信息

Hussein Almontaser, Farghaly Hekma, Askar Eman, Metwalley Kotb, Saad Khaled, Zahran Asmaa, Othman Hisham A

机构信息

Pediatric Department, Faculty of Medicine, Assiut University, Egypt.

Associate Professor of Pediatrics, Faculty of Medicine, University of Assiut, Assiut 71516, Egypt.

出版信息

Ther Adv Endocrinol Metab. 2017 May;8(5):75-80. doi: 10.1177/2042018817707464. Epub 2017 May 3.

Abstract

BACKGROUND

Accurate anthropometric measurements and critical analysis of growth data allow the clinician to promptly recognize children with short stature. The aim of this study was to determine the frequency of etiological factors causing short stature among children referred to the pediatric endocrinology clinic of Assiut University Children's Hospital, the main tertiary care center in Upper Egypt.

METHODS

We conducted this descriptive observational study from May 2012 to December 2015, to analyze 637 children (boys 354, girls 283) with short stature. Evaluation included: detailed medical history, physical examination, laboratory tests, bone age and chromosomal analysis.

RESULTS

Endocrinological causes accounted for 26% of short stature [of them, 11.8% had growth hormone deficiency (GHD)], 63.6% had normal variants of growth [of them, 42% had familial short stature (FSS), 15.8% had constitutional growth delay (CGD) and 5.5% a combination of both]. Interestingly, celiac disease (CD) constituted 6.6% of children with short stature in our cohort.

CONCLUSIONS

Although potentially treatable causes such as GHD, hypothyroidism and CD accounted for a considerable percentage of short stature in our study, the majority of short stature in children had normal variations of growth. Growth hormone treatment in children, however, should be promptly initiated with specific clinical indications. CD is a not uncommon cause of short stature.

摘要

背景

准确的人体测量以及对生长数据的批判性分析能使临床医生迅速识别身材矮小的儿童。本研究旨在确定转诊至阿斯尤特大学儿童医院儿科内分泌门诊(上埃及主要的三级护理中心)的身材矮小儿童中病因的发生频率。

方法

我们于2012年5月至2015年12月开展了这项描述性观察性研究,以分析637名身材矮小儿童(男孩354名,女孩283名)。评估内容包括:详细的病史、体格检查、实验室检查、骨龄和染色体分析。

结果

内分泌原因占身材矮小病例的26%[其中,11.8%患有生长激素缺乏症(GHD)],63.6%生长正常变异[其中,42%患有家族性身材矮小(FSS),15.8%患有体质性生长发育延迟(CGD),5.5%两者兼具]。有趣的是,乳糜泻(CD)在我们的队列中占身材矮小儿童的6.6%。

结论

尽管在我们的研究中,诸如生长激素缺乏症、甲状腺功能减退症和乳糜泻等潜在可治疗病因占身材矮小病例的相当比例,但大多数儿童身材矮小是生长的正常变异。然而,对于儿童,应根据特定的临床指征及时开始生长激素治疗。乳糜泻是身材矮小的一个常见病因。

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