[Growth disorders. Recommendations for a practice-oriented classification].

Area of Science:

• Pediatric Endocrinology
• Child Growth and Development
• Medical Diagnostics

Context:

• Growth disturbances are frequent reasons for pediatric consultations, alongside acute illnesses.
• Accurate diagnosis relies on detailed family and personal history, parental measurements for target height calculation, and growth charting on percentile curves.
• Hormone levels and bone age determination via X-ray are secondary diagnostic steps.

Purpose:

• To outline the diagnostic approach for pediatric growth disturbances.
• To differentiate between normal growth variants and pathological processes (proportionate vs. disproportionate).
• To identify treatable postnatal growth disorders and their therapeutic strategies.

Summary:

• Growth aberrations are classified as normal variants or pathological processes, with the latter potentially causing proportionate or disproportionate disturbances.
• Postnatal growth disorders amenable to therapy include isolated growth hormone deficiency, congenital adrenal hyperplasia, precocious puberty, and hypothyroidism.
• Treatment efficacy varies; hormone replacement is effective for specific endocrinopathies, while estrogen/gestagen therapy for tall stature shows limited results.

Impact:

• Effective treatment of primary diseases can improve secondary growth disturbances.
• Timely diagnosis and intervention can significantly improve outcomes for children with treatable growth disorders.
• Understanding the timing (pre- or postnatal onset) of growth deviation is crucial for therapeutic planning.