Endocrine diseases

Q. There are no tall people in our family. Our daughter is the shortest in her class. I do not see any problem in it, but our pediatrician recommended to see geneticist. Should we do it?

A. Most likely, you are right, and there is nothing to worry about. But in case your daughter is shorter than the third percentile (that means that only 3% of healthy children her age are the same height or shorter) you should refer to a specialist (geneticist - endocrinologist) in order to dissipate all doubts. The growth delay may be connected not only with family peculiarities, but with other reasons - growth hormone lack, chromosome diseases.

Q. What investigations should one have in order to find out the causes of growth delay?

A. To find out the cause of growth delay it is necessary to investigate the bone age of the child. The doctor makes an X-ray of child's hand. The next stage of the investigation is to define the level of the thyroid hormones, the markers of protein and mineral profiles, in case of necessity, the child should have an pelvic ultrasound check, thyroid gland, karyotype (chromosomes). If the doctor suspects a growth hormone shortage, an additional examination with special stimulation may be necessary.

Q. Why does a child need additional examination? Is not the "basal level of growth hormone" enough?

A. The matter is that growth hormone is produces by impulses. That is why the basal level of growth hormone may be "0" even in case the child is absolutely healthy. In order to see the real level of growth hormone various medications, intensifying its production, are used. Such investigation may be carried out only in the in-patient department.

Q. How long does it take to examine a child with growth or development delay?

A. The investigation may be carried out within one day in the AMC Day In-patient department.