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Growth and development in sickle cell anemia. Preliminary report
The American Journal of Pediatric Hematology/Oncology
|January 1, 1982
Summary
Children with sickle cell anemia experience reduced height and weight, with delayed sexual maturation. Longitudinal studies show bone age is a better indicator of development than chronological age.
Area of Science:
- Pediatrics
- Endocrinology
- Genetics
Background:
- Sickle cell anemia historically associated with specific physical characteristics.
- Previous studies on pediatric growth and sexual maturation in sickle cell anemia yielded conflicting results.
- Existing research primarily used cross-sectional data, limiting understanding of developmental trajectories.
Purpose of the Study:
- To longitudinally assess somatic growth and sexual maturation in children with sickle cell anemia.
- To compare growth and development against established health norms.
- To determine the appropriateness of hormonal replacement therapy.
Main Methods:
- Longitudinal evaluation of children with sickle cell anemia over 3 years at 6-month intervals.
- Assessment of height, weight, skin fold thickness, bone age, and Tanner staging.
- Measurement of pituitary gonadotropins and gonadal hormones.
Main Results:
- Reduced height and weight compared to National Health Statistics norms observed.
- Significantly retarded bone ages noted, with sexual development appropriate for bone age, indicating delayed maturation.
- Menarche was significantly delayed; pituitary gonadotropins increased appropriately with puberty, and gonadal hormone responsiveness was generally normal.
Conclusions:
- Longitudinal data reveals delayed somatic growth and sexual maturation in children with sickle cell anemia.
- Bone age is a more accurate predictor of sexual development than chronological age in this population.
- Hormonal replacement therapy is likely not warranted for the majority of patients.