Patient's question:
Main symptoms: No secondary sexual characteristics appearedOnset time: Test results: Uterine development is extremely poor, both ovaries are not visible
Doctor's answer:
1. Growth hormone deficiency is a condition that impairs children's growth and development due to insufficient secretion of growth hormone from the anterior lobe of the pituitary gland, referred to as growth hormone deficiency. Common causes of insufficient secretion of growth hormone by the anterior lobe of the pituitary include: ① Primary: Most children have abnormal pituitary development and hypothalamic-pituitary dysfunction, with the cause being unknown, and only a small portion is genetic, most of which have a family history of onset; ② Secondary: Tumors, radiation damage, head trauma, intracranial infections, and any lesions that damage the anterior lobe of the pituitary or hypothalamus can cause growth retardation. Sometimes, adverse environmental stimuli can cause psychological trauma in children, leading to temporary growth hormone deficiency, which can return to normal once these adverse factors are eliminated. Primary growth hormone deficiency is more common in boys. Children are born with normal height and weight, but growth retardation appears several weeks later, becoming gradually more apparent after 2-3 years of age. Their height is more than 30% lower than that of normal children of the same age, but the proportions of different body parts are still well-proportioned, and their intellectual development is also normal. With age, they may develop a lack of secondary sexual characteristics and underdeveloped sex organs. Once this condition is diagnosed, growth hormone replacement therapy should be started as early as possible, with the best results achieved when treatment begins at a younger age. Use under the supervision of a physician.2. Precocious puberty: Generally refers to the onset of sexual development in girls before the age of 8 or in boys before the age of 9, as early puberty shortens the growth period, ultimately leading to short stature. Precocious puberty refers to the presence of changes related to secondary sexual characteristics in girls before the age of 8 or in boys before the age of 9. When girls experience precocious puberty, they often have breast enlargement, accompanied by tenderness, usually occurring bilaterally, though it may also occur on one side. As the condition progresses, vaginal discharge may appear, followed by irregular bleeding, which is the onset of menarche. In boys, early puberty is characterized by loose scrotums, enlarged testicles, and increased penis length and thickness. Later on, voice changes and even nocturnal emissions may occur. The dangers of precocious puberty include two main points: 1) its impact on final height, and 2) its negative psychological effects on the patient, as the difference in physical development can lead to feelings of inferiority.
3. Congenital ovarian dysgenesis syndrome (also known as Turner syndrome): This is a sex chromosome abnormality disorder and a common cause of short stature in girls. In addition to short stature, it may have external features such as cubitus valgus (outward deviation of the elbows), low hairline, multiple facial nevi, and in some cases, intellectual disability and visceral malformations. Due to the absence of sex hormone secretion, there is no development of secondary sexual characteristics, and primary amenorrhea occurs. Organs such as the breasts, ovaries, and uterus are underdeveloped.
4. Congenital hypothyroidism. Children with this condition have intellectual disability and short stature, primarily in the limbs, and have a distinctive facial appearance: a large head, short neck, pale yellow complexion, rough skin, sparse hair, facial mucous edema, wide-set eyes, a flat nose bridge, and a large, thick tongue that protrudes outward, etc.
5. Other factors: ① Short stature caused by systemic diseases. Such as recurrent, persistent, and difficult-to-treat nephrotic syndrome, chronic nephritis, tuberculosis, diabetes, bronchial asthma, chronic diarrhea, etc. The degree of short stature in this case is related to the duration and severity of the primary disease. ② Malnutrition-related short stature. Caused by various diseases or poor dietary habits leading to insufficient nutrient intake or absorption. ③ Emotional deprivation-related short stature. Due to psychological factors such as family discord or loss of maternal love, the hypothalamus may secrete less growth hormone-releasing factor, leading to short stature. Therefore, a child's positive emotions are one of the keys to growing taller. ④ Other conditions, such as intrauterine growth retardation, hypochondroplasia or hypochondrogenesis, renal tubular acidosis, glycogen storage disease, Down syndrome (21-trisomy), and other chromosomal abnormalities, etc.