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Wang L. [Attaching great importance to the scientific assessment of short stature in children]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2023; 25:1095-1100. [PMID: 37990451 PMCID: PMC10672958 DOI: 10.7499/j.issn.1008-8830.2308063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 10/10/2023] [Indexed: 11/23/2023]
Abstract
Short stature is a common physical developmental abnormality in children. Without timely and accurate diagnosis, as well as early intervention, it can impose a heavy burden on the children and their families. There are numerous causes for short stature, and the diagnostic process essentially involves identifying its underlying causes. Based on a thorough understanding of the regular patterns of child physical development and the characteristics of individuals at high risk of short stature, a scientific definition of short stature needs to be established, along with standardized diagnostic and treatment protocols, to achieve early diagnosis or referral for short stature. Furthermore, it is necessary to enhance scientific awareness of short stature among parents and primary care pediatricians, in order to avoid over-treatment, missed diagnoses, and misdiagnoses arising from "misconceptions", and to improve the scientific assessment of short stature.
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Affiliation(s)
- Lin Wang
- Center of Children's Healthcare, Children's Hospital Affiliated to Capital Institute of Pediatrics, Beijing 100020, China (. cn)
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Mergulhão B, Almeida JP, Moreira H, Castro-Correia C, Bullinger M, Canavarro MC, Silva N. Quality of Life of Children and Adolescents with Short Stature: The Twofold Contribution of Physical Growth and Adaptive Height-Related Cognitive Beliefs. J Clin Psychol Med Settings 2022; 29:466-475. [PMID: 35511326 DOI: 10.1007/s10880-022-09871-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/10/2022] [Indexed: 11/28/2022]
Abstract
This study aimed to examine the health-related quality of life (HrQoL), coping, height-related beliefs, and social support of children/adolescents with short stature, the sociodemographic, clinical, and psychosocial variables associated with HrQoL, and the moderating role of sociodemographic and clinical variables on the associations between psychosocial variables and HrQoL. 114 Portuguese children/adolescents with short stature, aged 8-18 years old, completed the Quality of Life in Short Stature Youth questionnaire and the Satisfaction with Social Support Scale. Regression analyses explained 54% of the variance of HrQoL, with significant main effects of current height deviation and height-related beliefs, and a significant interaction effect between beliefs and diagnosis. Results suggest that a multidisciplinary therapeutic approach, not only focused on hormone treatment to boost physical growth, but also including psychosocial interventions focused on the modification of height-related beliefs, may contribute to improve the HrQoL of pediatric patients with short stature.
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Affiliation(s)
- Beatriz Mergulhão
- Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), Faculty of Psychology and Education Sciences, University of Coimbra, Rua do Colégio Novo, 3000-115, Coimbra, Portugal
| | - José Paulo Almeida
- Pediatric Endocrinology Unit, Integrated Pediatric Hospital, São João Hospital Center, Porto, Portugal
| | - Helena Moreira
- Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), Faculty of Psychology and Education Sciences, University of Coimbra, Rua do Colégio Novo, 3000-115, Coimbra, Portugal
| | - Cíntia Castro-Correia
- Pediatric Endocrinology Unit, Integrated Pediatric Hospital, São João Hospital Center, Porto, Portugal
| | - Monika Bullinger
- Department of Medical Psychology, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Maria Cristina Canavarro
- Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), Faculty of Psychology and Education Sciences, University of Coimbra, Rua do Colégio Novo, 3000-115, Coimbra, Portugal
| | - Neuza Silva
- Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), Faculty of Psychology and Education Sciences, University of Coimbra, Rua do Colégio Novo, 3000-115, Coimbra, Portugal.
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Kaplan W, Al Amiri E, Attia N, Al Basiri I, Romany I, Al Shehri E, Al Twaim A, Al Yaarubi S, Deeb A. Assessment and referral of patients with short stature by primary care physicians in the Arabian gulf region: Current perspectives from a regional survey. Front Pediatr 2022; 10:988614. [PMID: 36507126 PMCID: PMC9732663 DOI: 10.3389/fped.2022.988614] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 10/26/2022] [Indexed: 11/26/2022] Open
Abstract
Children with short stature are frequently referred late to pediatric endocrinologists in the Arabian Gulf region. This is likely a contributing factor to late initiation of treatment despite current evidence suggesting that children with short stature have better outcomes with earlier treatment. This delay in referral could be due to a lack of identification or proper assessment of short stature by front-line physicians. To analyze the assessment and perception of short stature in this group of physicians, an expert group of pediatric endocrinologists developed and disseminated an anonymous online survey of 22 multiple choice questions amongst general pediatricians, pediatric subspecialists, and family medicine physicians in the Arabian Gulf region. Of the 640 respondents, 450 completed the survey (70.3% completion rate). While most surveyed physicians use the correct definition for short stature in children, only 24% reported a consistent use of a wall-mounted stadiometer. Of the respondents, 50% or less would consider referring clinical conditions other than growth hormone (GH) deficiency or idiopathic short stature, 41% would refer a child with short stature as soon as height dropped below the 5th percentile, 57% considered GH a treatment option for short stature, and only 60% consider GH treatment safe. The results of this survey demonstrate knowledge gaps in short stature assessment and referral that need to be addressed through education on short stature amongst target physicians, and lay groundwork for future recommendations to address those gaps in the Arabian Gulf region.
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Affiliation(s)
- W Kaplan
- Department of Pediatrics, Tawam Hospital, Al Ain, United Arab Emirates
| | - E Al Amiri
- Diabetes and Endocrine Unit, Department of Pediatrics, Al Qasimi Women and Children Hospital, Sharjah, United Arab Emirates
| | - N Attia
- Pediatric Endocrine Unit, Department of Pediatrics, King Abdulaziz Medical City and King Abdullah Research Centre, Jeddah, Saudi Arabia
| | - I Al Basiri
- Diabetic and Endocrine Unit, Department of Pediatrics, Mubarak Al Kabeer Hospital, Kuwait City, Kuwait
| | - I Romany
- Department of Medical Affairs, Pfizer Gulf FZ LLC, Dubai, United Arab Emirates
| | - E Al Shehri
- Department of Pediatrics, International Diabetes Care Center, Jeddah, Saudi Arabia.,Pediatric Endocrine Division, Department of Pediatrics, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - A Al Twaim
- Department of Pediatrics, International Diabetes Care Center, Jeddah, Saudi Arabia
| | - S Al Yaarubi
- Department of Pediatrics, Oman Medical Specialty Board, College of Medicine and Health Science, Muscat, Oman
| | - A Deeb
- Division of Paediatric Endocrinology, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates.,College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates
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Alassaf A, Gharaibeh L, Ibrahim S, Odeh R. Etiologies, profile patterns and characteristics of children with short stature in Jordan. J Pediatr Endocrinol Metab 2021; 34:559-565. [PMID: 33851794 DOI: 10.1515/jpem-2020-0672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 02/02/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Childhood growth influences their social and psychological behavior, and abnormal growth may reflect underlying pathological etiologies. It is important to diagnose children with short stature as early as possible to be able to manage treatable causes. We aim to study etiologies and characteristics of short stature in children in Jordan. METHODS This is a cross-sectional retrospective review of the medical records of children diagnosed with short stature at a referral university hospital. Clinical characteristics, auxological, laboratory, and radiological investigations were collected and analyzed. RESULTS Among a total of 551 children diagnosed with short stature, the number of boys was significantly higher than girls, 304 (55.2%) and 247 (44.8%), respectively with a p-value of 0.015. Average age at presentation for all patients was 10.24 ± 3.23, with no significant difference between boys and girls. Pathological etiology was higher than normal variants 55.7 and 44.3%, respectively with p=0.007. Constitutional delay of growth and puberty (CDGP) was the most frequent cause in the normal variant group, 59.8%. Among the pathological group, the most common etiology was growth hormone deficiency (32.2%) with mean age of presentation of 9.40 years and was not significantly different from the age in other etiological groups, 9.44 years and p=0.931. CONCLUSIONS Growth monitoring of children should start at an early age for boys and girls. Referral to the pediatric endocrine clinic should be considered when growth problems are suspected for accurate diagnosis and etiology profiling.
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Affiliation(s)
- Abeer Alassaf
- Department of Pediatrics, The University of Jordan, Amman, Jordan
| | - Lobna Gharaibeh
- Pharmacological and Diagnostic Research Center, Faculty of Pharmacy, Al-Ahliyya Amman University, Amman, Jordan
| | - Sarah Ibrahim
- Department of Pediatrics, The University of Jordan, Amman, Jordan
| | - Rasha Odeh
- Department of Pediatrics, The University of Jordan, Amman, Jordan
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Essaddam L, Kallali W, Cherifi E, Guedri R, Mattoussi N, Fitouri Z, Ben Becher S. Characteristics and etiologies of short stature in children: Experience of an endocrine clinic in a Tunisian tertiary care hospital. Int J Pediatr Adolesc Med 2019; 7:74-77. [PMID: 32642540 PMCID: PMC7335824 DOI: 10.1016/j.ijpam.2019.07.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Accepted: 07/02/2019] [Indexed: 11/24/2022]
Abstract
Background Short stature is a common reason for referral to pediatric endocrinology clinics. It may be a manifestation of a pathological condition requiring early treatment. The aim of this study was to describe the characteristics and etiologies of short stature among children referred to the pediatric endocrinology clinic of the main pediatric tertiary care center in Tunisia. Methods Retrospective and descriptive study in the endocrinology unit of children referred for short stature between January 2012 and December 2016. Data on the patients' medical history, physical findings, laboratory tests, bone age and chromosomal analysis were collected. Results 470 children (266 males and 204 females) were referred during that period. 214 (45.5%) had normal height, and 80.8% of them were referred by general practitioners. The other 256 children (54.5%) had a confirmed short stature (mean age :7.2 years, mean height: -2.77 SDS). Endocrinological causes were the most common(43% GHD, 4% hypothyroidism) followed by intrauterine growth retardation IUGR (24%), genetic syndromes (8.4%), chronic pediatric diseases (7.8%), skeletal dysplasia (6.2%), normal variant of short stature (5%), and psychosocial deprivation (1.2%). Among non-endocrine causes, Turner syndrome was the most common genetic syndrome (4.4%), achondroplasia the main skeletal dysplasia (4%) and celiac disease the main chronic disease (3.4%). Conclusions ST is largely overestimated in our country. Therefore, it is important to insist on adequate measurement and analysis of growth parameters to avoid unnecessary investigations. GHD and IUGR were the most common causes. Celiac disease, though frequent in Tunisia, is not a common cause of short stature.
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Affiliation(s)
- Leïla Essaddam
- Université de Tunis El Manar, Faculté de Médecine de Tunis, 1007, Tunis, Tunisia.,Children Hospital Béchir Hamza de Tunis, Jebbari, 1007, Tunis, Tunisia
| | - Wafa Kallali
- Université de Tunis El Manar, Faculté de Médecine de Tunis, 1007, Tunis, Tunisia.,Children Hospital Béchir Hamza de Tunis, Jebbari, 1007, Tunis, Tunisia
| | - Emna Cherifi
- Université de Tunis El Manar, Faculté de Médecine de Tunis, 1007, Tunis, Tunisia.,Children Hospital Béchir Hamza de Tunis, Jebbari, 1007, Tunis, Tunisia
| | - Rahma Guedri
- Université de Tunis El Manar, Faculté de Médecine de Tunis, 1007, Tunis, Tunisia.,Children Hospital Béchir Hamza de Tunis, Jebbari, 1007, Tunis, Tunisia
| | - Nadia Mattoussi
- Université de Tunis El Manar, Faculté de Médecine de Tunis, 1007, Tunis, Tunisia.,Children Hospital Béchir Hamza de Tunis, Jebbari, 1007, Tunis, Tunisia
| | - Zohra Fitouri
- Université de Tunis El Manar, Faculté de Médecine de Tunis, 1007, Tunis, Tunisia.,Children Hospital Béchir Hamza de Tunis, Jebbari, 1007, Tunis, Tunisia
| | - Saayda Ben Becher
- Université de Tunis El Manar, Faculté de Médecine de Tunis, 1007, Tunis, Tunisia.,Children Hospital Béchir Hamza de Tunis, Jebbari, 1007, Tunis, Tunisia
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