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Published on: July 23, 2012
Short stature and delayed skeletal maturation in children with allergic disease
Insights
Short stature is common in children with allergic respiratory diseases like asthma. These children often have good growth potential, suggesting underlying atopic conditions may affect height, not just asthma itself.
Area of Science:
- Pediatric Endocrinology
- Allergology
- Genetics
Background:
- Short stature is a concern in pediatric health.
- Asthma and allergic rhinitis are common conditions in children.
- The relationship between allergic respiratory diseases and growth is not fully understood.
Purpose of the Study:
- To determine the frequency of short stature in children with asthma or allergic rhinitis.
- To investigate the characteristics of children with short stature and allergic respiratory disease.
- To explore potential causes of impaired linear growth in this population.
Main Methods:
- Cross-sectional study of 598 children referred for asthma or allergic rhinitis.
- Assessment of height, bone age, and hormonal levels in children with short stature (height < 3rd percentile).
- Comparison of growth parameters between asthmatic and non-asthmatic children.
Main Results:
- Six percent of referred children had short stature.
- Children with short stature were predominantly male, exhibiting delayed bone age and normal growth hormone secretion.
- Impaired linear growth was observed in both asthmatic and non-asthmatic children, unrelated to asthma severity.
- Thyroid hormone levels showed normal thyroxine but elevated tri-iodothyronine.
Conclusions:
- Short stature is more prevalent than expected in children with allergic respiratory diseases.
- Growth potential appears good, suggesting factors beyond asthma contribute to short stature.
- The atopic state may be linked to a fundamental abnormality affecting linear growth.
- Allergic respiratory disease warrants consideration in the evaluation of pediatric short stature.
Abstract:
The frequency of short stature was assessed in 598 children (66% boys, 34% girls) referred consecutively because of asthma or allergic rhinitis. Six percent were of small stature, with heights of less than the third percentile for age. A total of 66 children with small stature were subsequently studied, 36 of whom had asthma. None had received steroids. Children with short stature were predominantly boys (83%, p less than 0.005) and had delayed bone age (less than 2 SD of mean, 34/45), correspondence of bone age with height age (r = 0.93), normal serum thyroxine but increased tri-iodothyronine levels (11/24), and normal insulin-induced growth hormone secretion (12/12). Their heights corresponded only in part to midparental height. The results were the same for those with and without asthma, and the severity of asthma was not related to the degree of growth retardation. The findings suggest that short stature is more common than expected in children with allergic respiratory disease, both asthmatic and nonasthmatic, that their growth potential is good, and that impaired linear growth is not necessarily a result only of asthma but of a more fundamental abnormality possibly associated with the atopic state. They emphasize the importance of considering allergic respiratory disease in the clinical evaluation of children with small stature.
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