What is a growth disorder?
Growth is an important sign that your child is healthy, and occurs at different rates in every child. There are many factors that may impact growth. In some cases, the reason may be a medical condition known as a growth disorder. Growth disorders are problems that prevent children from developing normal height, weight, sexual maturity, or other features.1
The most common growth disorder is growth hormone deficiency (GHD)
GHD is one of many growth disorders that a child can be born with, or it can develop over time.2 Growth hormones help the body develop into adulthood. For example, sex hormones drive growth during puberty.3 The growth hormone somatropin helps children grow from birth until they meet their full height potential.4
What causes GHD in children?
The body’s pituitary gland produces the growth hormone somatropin. When it doesn’t produce enough for normal development, the child can have growth hormone deficiency (GHD).5,6 It affects girls and boys, and about 18,000 to 22,000 children in the US have it.7-9
- “Total GHD” is when no growth hormone is produced in children5
- “Partial GHD” is when some is produced in children, but not enough for normal growth.5
Types of GHD
“Congenital GHD” means that the child was born with this condition. From birth, the child’s body doesn’t produce enough (or any) growth hormone. Typically they are below the 3rd percentile on the growth curve, even as an infant.10
Damage to the pituitary gland or other areas of the body involved with growth after birth can result in “acquired GHD.” It can be the result of serious illness, such as a tumor affecting the hypothalamus or pituitary gland, exposure to radiation therapy, or even a head injury.5
GHD can also occur in adults
For adults, growth hormone plays an important role in bone health, muscle growth, and keeping the metabolism in balance. When adults are deficient in growth hormone, the body is not properly nurtured, sending them down an unhealthy path.
GHD in adults is a result of damage to the pituitary gland from an accident or trauma (for example, a head injury, surgery, or radiation treatment). The most common cause of Adult GHD is a pituitary tumor, which leads to low production of growth hormone.11
Adults with low IGF-1 levels due to growth hormone deficiency may be candidates for treatment with ZOMACTON.
Diagnosing GHD in children
A pediatrician will look at a child’s current height and weight, as well as his/her birth height and weight. If there are no other symptoms, the pediatrician may monitor the child’s growth. If your pediatrician suspects there may be a problem, a referral to a specialist may be made.
When it comes to GHD, a diagnosis is made using several approaches, including6:
- An assessment of the child’s growth history
- Lab tests to rule out other causes of short height
- A blood test that measures growth hormone levels
- A growth hormone stimulation test
What are some other causes of growth failure?
GHD is just one reason why some children experience slow or no growth. There are many other medical conditions that may also cause short stature in children. Here are a few, which ZOMACTON can treat.12
What is Turner syndrome?
Turner syndrome is a rare genetic disorder that affects 1 in 2500 females. It is caused by a problem with one of the two X chromosomes found in females. Girls with Turner syndrome often have short stature and loss of ovarian function. However, while some girls may have many physical differences and certain health problems, others may have few.13
Idiopathic Short Stature (ISS)
In ISS, the reason for a child’s short stature is unknown. Children with ISS are significantly shorter than 98.8% of other children of the same age and gender. However, there may be no detected medical reason for slowing growth.14
What is SHOX deficiency?
SHOX deficiency is a genetic disorder that is a common cause of short stature in children. SHOX is an important growth gene located on the X and Y chromosomes that plays a role in short stature in humans if the gene is mutated. In SHOX deficiency, short stature is mainly characterized by shortening of the extremities and can also be associated with Turner syndrome, Leri-Weill syndrome, and some cases of ISS.15
What is SGA?
SGA is a term used for babies who are born with a birth weight below the 3rd percentile, which means that they are smaller than most other babies who were born after the same number of weeks of gestation (time in womb). There are many factors that can lead to SGA, with up to 10% of live births being diagnosed with this condition. 1 of 10 children fail to achieve catch-up growth by age 2 and are often referred to as “short SGA.”16
Know when to see a doctor
As a parent, you are your child’s advocate. If you see any of the following signs, talk to your pediatrician or see a specialist, typically a pediatric endocrinologist, immediately. Your child has a limited time to grow and getting him or her treated appropriately is essential to ensuring maximum growth.6
- Slow growth
- Short height
- Chubbiness (more fat around the face and stomach)
- Young-looking face for age
- Delayed or absent puberty
Evaluating your child’s growth
Understanding what is appropriate growth for your child is important. This can be done by comparing your child's measurement with other children their age. You can do this with the appropriate growth chart from the World Health Organization below. Most children fall between the 15th and 85th percentiles.
Questions to ask your doctor:
- Should I be worried about my child’s height?
- What tests show if there’s a growth deficiency?
- What can I do about a possible growth deficiency?
- What treatments are available?
- How could my child’s development be affected?
- Where can I get more information and support?
A leader in support, advocacy, education, and other topics related to endocrine health.
A group focused on helping people access quality genetic services that are needed for comprehensive healthcare.
A non-profit, voluntary organization dedicated to helping children and adults with growth disorders.
A patient advocacy organization dedicated to people with rare diseases and the groups that support them.
References: 1. MedlinePlus. Growth Disorders. https://medlineplus.gov/growthdisorders.html. Accessed February 5, 2019. 2. Hormone Health Network. Growth Hormone Deficiency. https://www.hormone.org/diseases-and-conditions/children-and-teen-health/growth-hormone-deficiency. Accessed November 12, 2018. 3. KidsHealth from Nemours. Endocrine system. http://kidshealth.org/en/teens/endocrine.html#. Accessed November 12, 2018. 4. Reh CS, Geffner ME. Somatropin in the treatment of growth hormone deficiency and Turner Syndrome in pediatric patients: a review. Clin Pharmacol. 2019;2:111-122. 5. Rieser PA. Pediatric growth hormone deficiency. In: Owens RP, Root AW. Growth Hormone Deficiency. The Human Growth Hormone Foundation Booklet. 1979. 6. The Hormone Health Network. Growth Hormone Deficiency in Children Fact Sheet. https://www.hormone.org/-/media/hormone/files/questions-and-answers/pediatric/fs_gd_growth_hormone_defic_children_en612.pdf?la=en. Accessed November 12, 2018. 7. Boston Children’s Hospital. Growth hormone deficiency in children. http://www.childrenshospital.org/conditions-and-treatments/conditions/growth-hormone-deficiency. Accessed November 12, 2018. 8. US Census Bureau 2015 Population Estimates. 9. Lindsay R, Feldkamp M, et al. Utah Growth Study: growth standards and the prevalence of growth hormone deficiency. J Pediatrics. 1994;125:29-35. 10. The MAGIC Foundation. Endocrine Disorders. https://www.magicfoundation.org/growth-disorders/. Accessed November 12, 2018. 11. The MAGIC Foundation. Adult growth hormone deficiency. https://www.magicfoundation.org/Growth-Disorders/Growth-Hormone-Deficiency-in-Adults/. Accessed November 12, 2018. 12. ZOMACTON [prescribing information]. Parsippany, NJ: Ferring Pharmaceuticals Inc. 13. The MAGIC Foundation. Turner syndrome. https://www.magicfoundation.org/Growth-Disorders/Turner-Syndrome/. Accessed November 12, 2018. 14. The MAGIC Foundation. Idiopathic short stature. https://www.magicfoundation.org/Growth-Disorders/Idiopathic-Short-Stature/. Accessed November 12, 2018. 15. Leka SK, Kitsiou-Tzeli S, Kalpini-Mavrou A, Kanavakis E. Short stature and dysmorphology associated with defects in the SHOX gene. Hormones. 2006;5(2):107-118. 16. The MAGIC Foundation. Small for gestational age. https://www.magicfoundation.org/Growth-Disorders/Small-for-Gestational-Age/. Accessed November 12, 2018.