Growth monitoring still has a place in selected populations of children.
In 1998, a multiprofessional group developed a consensus on growth monitoring in the UK. While routine serial measurements were not recommended in healthy children, it is clear that there is a subset of children at increased risk of growth-modifying disease who may benefit from growth monitoring. This subset includes children with genetic disorders at increased risk of thyroid dysfunction. Symptoms and signs of thyroid dysfunction are non-specific in the early stages of disease and are easily mistaken for features of an underlying genetic disorder. In this article, we report the case of a 2.8-year-old girl with 18q deletion syndrome who was profoundly weak, hypotonic and poorly responsive at diagnosis of Grave's disease. She was tall and her bone age was 2 years advanced, indicating long-standing disease. Growth monitoring of this patient should have enabled earlier diagnosis and avoided a serious and potentially fatal episode.
Department of Paediatric Endocrinology, Alder Hey Children's Hospital, West Derby, Liverpool, UK.
M
M
Hussain
C M
CM
John
K
K
Mohamed
M
M
Zbaeda
S M
SM
Ng
S
S
Chanderasekaran
M
M
Didi
J C
JC
Blair
D002675:Child, Preschool; D002872:Chromosome Deletion; D025063:Chromosome Disorders / Q000150:complications*; D002887:Chromosomes, Human, Pair 18; D057210:Delayed Diagnosis; D005260:Female; D006111:Graves Disease / Q000150:complications / Q000175:diagnosis*; D057238:Growth Charts; D006801:Humans