Dwarfism Unveiled: Exploring the Causes of Stunted Growth and the Side Effects of Growth Hormone Injections

Parents are often deeply concerned about their child's growth issues, whether it's being too short, overweight, or underweight. Take the example of Lionel Messi, the Argentine football legend who recently won the World Cup. During his childhood, he was diagnosed with "dwarfism" - a deficiency of growth hormone that required nightly injections. When it comes to children's growth concerns, Dr. Tsui Tsz Kwan, a pediatric specialist, shares the following insights.

Question 1: What is Growth Hormone Deficiency (GHD)?

Dr. Tsui: The pituitary gland in the brain produces growth hormone, a vital component for healthy growth and development in children. This hormone continuously regulates various physiological and metabolic processes throughout different stages of life.

Although Growth Hormone Deficiency is not common, if left untreated, it can result in stunted growth, weakened bones, and impaired physical abilities. Research data suggests that approximately one person out of every 4,000 to 10,000 individuals is affected by GHD, leading to short stature. Children with GHD may also exhibit distinct facial features compared to their peers, along with a higher percentage of body fat and a more rounded abdomen. Fortunately, GHD does not affect intelligence.

Question 2: How should parents observe their child's growth on a regular basis?

Dr. Tsui: If parents are concerned about their child's height, it is advisable to measure their height every 4-6 months. Generally, children between the ages of 4 and 10, before the onset of puberty, can grow around 4-6cm per year. If parents notice that their child is shorter than their peers or experiencing slower growth, it is recommended to consult a pediatrician for an early evaluation.

Question 3: What are the causes of dwarfism?

Dr. Tsui: Generally, the causes can be categorized as non-pathological or pathological. Non-pathological causes include genetic factors, delayed individual maturation, delayed growth and development, as well as unexplained cases of dwarfism. On the other hand, pathological causes encompass low birth weight, malnutrition, chronic illnesses such as chronic kidney disease, genetic or chromosomal variations, and even endocrine disorders like hypothyroidism or growth hormone deficiency.

Question 4: How can dwarfism be treated? Can growth hormone injections help?

Dr. Tsui: The treatment for stunted growth depends on the underlying cause. For instance, if it is due to poor nutrition or unhealthy lifestyle habits, attention should be given to maintaining a balanced diet, adequate rest, and regular exercise. Additionally, assessing the possibility of adjusting medication may be necessary. If the cause is hormonal imbalance, such as hypothyroidism, restoring thyroid function can help normalize growth. In cases where growth hormone deficiency is detected, treatment with growth hormone injections often leads to significant improvements in height.

Question 5: What is growth hormone, and does it have any side effects?

Dr. Tsui: The growth hormone used for treatment is a synthetic medication that has been used for over 30 years in managing dwarfism. Its efficacy and potential side effects have been extensively studied. While a small number of children may experience adverse effects such as headaches, joint pain, swelling, or high blood sugar, these side effects are generally temporary and resolve once the treatment is discontinued. Some individuals may develop benign intracranial hypertension, which can cause symptoms like headaches and vomiting. However, these side effects are rare. In extremely rare cases, a serious condition called slipped capital femoral epiphysis may occur, requiring surgical intervention. Overall, the use of growth hormone injections for treating dwarfism is considered safe.

The United States Food and Drug Administration (FDA) has approved the use of growth hormone for the treatment of growth hormone deficiency, Turner syndrome, Prader-Willi syndrome, stature-related to SHOX gene deletion, chronic kidney disease-associated short stature, unexplained short stature, and children born small for gestational age. However, before initiating treatment with these medications, a thorough evaluation by a healthcare professional is essential to determine suitability.