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A boy with psychosocial short stature followed up from infancy to adulthood
1Department of Pediatrics, Kanagawa Children's Medical Center, Yokohama, Japan.
Insights
This case study details a boy with psychosocial short stature who experienced significant growth and developmental improvements after being moved to an orphanage. His physical growth, behavior, and IQ all normalized, demonstrating the impact of environment on development.
Area of Science:
- Pediatrics
- Endocrinology
- Psychology
Background:
- This report details the long-term follow-up of a male individual from infancy to adulthood.
- The case involves psychosocial short stature, stemming from an unwanted pregnancy and an impaired mother-son relationship.
Observation:
- The patient exhibited severe malnutrition, short stature, behavioral issues, and voracious appetite in early childhood.
- Hormonal testing revealed initially insufficient growth hormone secretion, which normalized during catch-up growth.
- Hospitalization led to temporary weight and height gains, with subsequent losses at home.
Findings:
- Environmental change, specifically institutionalization from age 6 to 15, resulted in rapid catch-up growth.
- Abnormal behaviors resolved, and intelligence quotient (IQ) increased significantly during institutional care.
- The patient achieved normal adult height (169.5 cm) and normal secondary sexual characteristics.
Implications:
- This case highlights the profound impact of psychosocial environment on physical growth, behavior, and cognitive development.
- Early intervention and a stable environment are crucial for children experiencing psychosocial deprivation.
- The findings underscore the reversibility of growth and developmental deficits when adverse environmental factors are removed.
Abstract:
A boy with psychosocial short stature who has been followed up from the age of 11 months to adulthood is described. The boy was the product of an unwanted pregnancy. The emaciated short boy gained weight and height markedly during a short-term stay at hospital, but lost weight and experienced minimal height gain at home. On the fourth hospital admission at the age of 6 years 3 months the boy weighed 10 kg and measured 85.7 cm, he was malnourished and exhibited strange behavior and had a voracious appetite. He was examined endocrinologically and provocative tests performed early after admission showed insufficient growth hormone secretion, although this recovered later at a time of catch-up growth. The boy was reared in an orphanage from the age of 6 years 5 months until the age of 15 years 3 months. His growth rapidly caught up to a normal rate, his abnormal behavior disappeared, and he demonstrated an increased IQ. He attained 169.5 cm at the age of 17.5 years and possessed normal secondary sexual characteristics. After graduating from senior high school the patient has been living happily by himself without intervention from his mother, and is working in a Chinese restaurant. The impaired relationship between the boy and mother has never been restored. The record of growth and development described in this case is the longest ever reported.