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Non-organic failure to thrive complicated by benign intracranial hypertension during catch-up growth

L Alison1, C J Hobbs, H G Hanks

  • 1Department of Community Paediatrics, St James's University Hospital, Leeds, UK.

Insights

A 9-year-old boy experienced severe failure to thrive due to abuse. After a caregiver change, he showed catch-up growth, but developed benign intracranial hypertension with headaches and vomiting.

Area of Science:

  • Pediatric Endocrinology
  • Child Abuse and Neglect
  • Growth Disorders

Background:

  • Non-organic failure to thrive (NOFTT) in children can stem from severe physical and emotional abuse.
  • Food deprivation is a critical factor contributing to NOFTT.

Observation:

  • A 9-year-old boy presented with severe NOFTT secondary to documented abuse and food deprivation.
  • Following a change in his living situation and care, the boy exhibited rapid catch-up growth in both weight and height.

Findings:

  • The patient demonstrated a poor initial growth hormone response to clonidine stimulation.
  • Recovery of normal growth hormone secretion coincided with the development of benign intracranial hypertension.
  • Symptoms of intracranial hypertension included headaches and vomiting.

Implications:

  • This case highlights the complex interplay between severe psychosocial stress, nutritional deficits, and endocrine function in children.
  • The resolution of growth deficits and subsequent development of benign intracranial hypertension suggest a potential link between nutritional rehabilitation and cerebrospinal fluid dynamics.
  • Further research into the mechanisms connecting nutritional recovery, growth hormone dynamics, and intracranial pressure in abused children is warranted.

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