[Psychosocially stunted growth masked as growth hormone deficiency].
Short stature is a common reason for presenting a child to the pediatrician. Emotional deprivation may cause short stature and may simulate growth hormone deficiency. Diagnosis of emotional deprivation as the cause of growth retardation is difficult and misdiagnosed frequently despite of suspicious clinical signs. We report on 2 patients with growth retardation because of emotional deprivation. At the age of 5 years both children had a severe growth hormone deficiency. They received therapy with growth hormone and showed an increase of growth velocity to > or = 8 cm in the first year of treatment. But in the third year of treatment both patients showed a diminished response to the growth hormone therapy. During the period of observation the features of emotional deprivation became obvious through the extreme behavioural abnormalities. Both children showed disturbances in their social behaviour, and striking disorders concerning eating and digestion. The families of these children had severe social problems; alcoholism, low income and rejection of the child were risk factors. Removal from the current environment led to a characteristic increase of the growth velocity. Growth hormone deficiency was spontaneously reversible, so that treatment with growth hormone was terminated. The social environment and the psychical prosperity are essential growth factors in childhood and adolescence. The common features and risk factors of emotional deprivation are described. Spontaneous catch-up growth after removal from the current environment distinguishes this form of short stature from the other organic growth disorders.
Doeker
B
B
Vestische Kinderklinik Datteln, Universität Witten-Herdecke.
Simić-Schleicher
Hauffa
B P
BP
Andler
W
W
D001827:Body Height; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D004393:Dwarfism, Pituitary / Q000175:diagnosis* / Q000209:etiology; D005183:Failure to Thrive / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology* / Q000628:therapy; D005260:Female; D019382:Human Growth Hormone / Q000172:deficiency* / Q000378:metabolism / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D010287:Parent-Child Relations; D012931:Social Environment; D012960:Socioenvironmental Therapy; D016896:Treatment Outcome
D019382:Human Growth Hormone