Short Stature

Short Stature Basics

Acronyms Medical

Short stature, short stature, or short stature are common slang terms for microsomia. It is not initially an independent disease, but can appear as a symptom of many different diseases. However, it often results in further complaints in the lives of those affected.

What is short stature?

Short stature itself is not a symptom. It is a sequela of nutritional, idiopathic, intrauterine, metabolic, chromosomal, endocrine, or dysplasia conditions.

Around 100,000 people in Germany are considered to be of short stature. They are often still marginalized and discriminated against in society today and do not get the same opportunities as “normal-sized” people.┬áSee AbbreviationFinder for abbreviations related to Short Stature.

Short stature is defined as significantly restricted body growth that falls below the norm, the occurrence of which, thanks to ancient sculptures, can be traced back to ancient Egypt, i.e. almost 5000 years. In men, a height of no more than 1.50 m and in women a height of no more than 1.40 m is considered short stature.

Some sufferers do not even measure a meter. The medical term is microsomy. Although pathological changes in the structure of the skeleton can also lead to a very small body size, which can sometimes also fall below the limit of 1.50 m or 1.40 m, they are still not referred to as short stature.

Causes

Short stature can have various causes, but in most cases they restrict the production of the growth hormone somatropin, which leads to a restriction in physical growth. In addition to a metabolic disease or an unhealthy lifestyle on the part of the mother during pregnancy (smoking, alcohol or drug abuse), a brain tumor, a hormonal disorder or defective hereditary factors can also trigger insufficient growth.

Researchers at the University of Leipzig recently identified a gene that causes short stature. However, it is not absolutely necessary that one of the two parents also suffers from short stature, since the gene can remain inactive for several generations.

Furthermore, even a disturbed social environment, such as a dysfunctional family, can delay physical development and thereby produce short stature. Despite the large number of triggers that have already been discovered, by no means all of them have been revealed. Overall, experts suspect over 450 different causes of short stature.

Typical diseases

  • Noonan Syndrome
  • Prader-Willi Syndrome
  • Brittle bone disease (osteogenesis imperfecta)
  • Cat Cry Syndrome (Cri-du-Chat Syndrome)
  • cretinism

Symptoms, Ailments & Signs

Despite numerous causes, short stature (microsomia) cannot be regarded as an independent disease. Short stature itself is not a symptom. It is a sequela of nutritional, idiopathic, intrauterine, metabolic, chromosomal, endocrine, or dysplasia conditions. Short stature does not always have to result in physical problems.

Nevertheless, due to their genetic disposition, people of short stature can suffer from various ailments and symptoms associated with their short stature. Since there are various triggers for short stature, these must first be determined. In this way, possible complaints can be countered as early as possible. The symptoms that arise vary from person to person.

In addition to mental stress to which people of short stature are exposed throughout their lives, hearing problems or deafness can occur as accompanying symptoms in the case of achondroplasia-related short stature due to skeletal dysplasia in the mother. In addition, achondroplasia can lead to subsequent symptoms such as age-appropriate joint wear and severe back pain. Idiopathic short stature tends to run in families.

In children of short stature, in whom the production of the growth hormone somatropin is impaired, treatment with growth hormones during childhood can lead to an increase in body size. If the short stature occurs as a result of a skeletal dysplasia such as osteogenesis imperfecta, the bones of those affected break easily. Doctors therefore also speak of the brittle bone disease. It is based on a disturbance in collagen synthesis. This can result in short stature and painful skeletal deformities.

Diagnosis & History

Short stature can already be detected in infancy if the child is observed closely. In about 5 percent of births with a normal course, the children are too small, but almost 90 percent of them make up for this deficit within two years.

However, as a precaution, newborns with a size deficit should be evaluated by a specialist, such as a pediatric endocrinologist, who can use X-rays of the left hand to determine bone age, diagnose cerebral disease, or detect decreased growth hormone secretion.

In addition, the pediatrician also documents the physical development of the child during the check-ups and can sound the alarm if he suspects a short stature.

Complications

When achondroplasia is the cause of short stature, life expectancy is not significantly affected. However, complications can still occur due to the growth disturbance. One of the conceivable complications often occurs as a result of mental stress.

Short people are marginalized in society. They face countless difficulties to cope with their everyday life. This can put a lot of mental strain on those affected, sometimes leading to depression. Overall, however, the attitude towards people of short stature has become more tolerant.

Especially when children are affected by short stature, the cruelty of others often knows no mercy. Children with achondroplasia also often suffer from damage to the ears. You have trouble hearing. Some experience complete hearing loss. This puts additional strain on the psyche. Thoughts of suicide are possible, especially during puberty.

Complications of achondroplasia-related short stature often result from a developmental delay. These can result in mental limitations, but also in malformations. This often leads to sensory disturbances. It is also problematic that achondroplasia offers hardly any treatment options. The symptoms of short stature can only be partially corrected, usually surgically. Complications within the family may necessitate therapeutic interventions for those affected.

When should you go to the doctor?

If a growing child shows a particularly small stature in direct comparison to peers of the same age, a doctor should be consulted to clarify the abnormality. The first indications can already be noticed in the first months of life if the relatives are carefully observed. Since low physical growth is an accompanying symptom of an existing disease, further investigations are necessary. Regular check-ups to check the state of health of the newborn often take place during infancy.

During these checks, the changed growth of the child can already be discussed with the pediatrician. In many cases there are genetic dispositions, metabolic diseases, brain diseases, hormonal disorders or other life-threatening diseases that need to be diagnosed and treated. To ensure that no serious disturbances occur in the further development process of the child, the size deficit can be determined in good time using tests and imaging procedures.

If there are problems with the musculoskeletal system, mobility restrictions or joint problems, a doctor should be consulted. If psychological peculiarities appear or if behavioral problems occur, the child needs therapeutic support. Cognitive impairment, pain, bone cracking, and general malaise require a doctor’s visit. Learning disabilities, memory disorders, skin irregularities, facial deformities or anomalies in hair growth must also be examined by a doctor.

Treatment & Therapy

The treatment options are varied and must be adapted to the respective trigger for the short stature. In the case of insufficient production of the growth hormone somatropin, for which the pituitary gland is normally responsible, this can be compensated for by the administration of artificially produced somatropin and in many cases lead to normal growth of the child.

However, the short stature must be diagnosed at an early stage and treatment initiated at a very young age, since treatment would no longer be effective once the growth plates have closed. In other cases, physiotherapy can also lead to an improvement in growth. If therapy was started too late or if it is simply not possible to treat the short stature, there is also the option of surgically lengthening the arms and legs, which can make the patient up to 20 cm taller.

Arms and legs are broken first, and splints are then used to connect them together to artificially lengthen the bones. However, this is very time-consuming and associated with great inconvenience, since more than ten operations are often necessary to achieve a satisfactory result and to overcome the short stature.

Outlook & Forecast

People who have been diagnosed with short stature receive an unfavorable prognosis in most cases. Ultimately, however, the course of the disease depends on the causal disorder. Basically, there will be no relief of symptoms if medical treatment is refused.

If the short stature is based on insufficient production of the growth hormone somatropin, this can be treated as part of medical treatment. Early diagnosis is crucial for recovery. A change in body size is possible during the growth process of a child or adolescent. If the drugs are administered during the development process, there is a chance of reaching a normal size.

For most patients, no freedom from symptoms can be expected even with the administration of medication. Short stature is not an independent disease, but is found in a large number of cases as a symptom of an existing underlying disease. This is often serious and requires medical attention. Physical growth is taken into account when creating the treatment plan, but often cannot be changed in such a way that the patient’s normal height is achieved.

Many of those affected develop various secondary diseases due to the physical abnormalities. Mental and emotional impairments occur, which in the further course increase the probability of a mental disorder occurring.

Prevention

Either way, people with short stature have a harder time in life than people over the age of four, be it at work, in education or in everyday life. Despite positive developments in recent decades, people with short stature are still the target of discrimination and prejudice.

Aftercare

One of the aims of aftercare is to prevent the disease from reoccurring. However, this may not be effective in the case of short stature. The disease can no longer be cured from the age of majority. Only in adolescents can growth be influenced under certain circumstances.

For example, hormone therapy promises success. Short stature also has no compelling effect on life expectancy. In many cases there is no reason for medical measures. Problems arising from short stature usually affect the psychosocial area. If people experience exclusion as well as professional and private disadvantages, a mental imbalance often arises.

As part of a therapy, those affected are instructed to learn new self-confidence and experience other perspectives in life. Another goal of aftercare, namely to provide everyday support with aids, is usually not necessary. Furnishings and workplaces can be adapted to the body size of the short stature. Employers receive financial support from the state for integration.

In contrast to a tumor disease, short stature usually does not entail any follow-up care. The life expectancy of affected people does not have to be reduced. Physical complaints are not necessarily to be expected. Patients can cope with a normal everyday life. Conflicts result from psychosocial disadvantages and can be overcome with accompanying therapy.

You can do that yourself

In the case of short stature, the person concerned has no way of changing his height with his own strength. Despite his best efforts, he cannot change anything about the physical requirements, as these will remain largely stable for the rest of his life. On the other hand, the person affected can do a lot for themselves and their emotional well-being despite the physical flaw.

With a healthy lifestyle, a balanced diet and sufficient exercise, life satisfaction generally increases immensely. In addition, a stable social environment, regular leisure activities and professional recognition are important in order to successfully master everyday challenges. Emotional stability and various strategies for overcoming mental obstacles also help to experience a lasting zest for life. With a strong sense of self-confidence and self-esteem, many people affected by short stature are able to cope with the physical issues.

In everyday life, it is helpful if the interior design or means of transport are adapted to the needs of the patient. This enables an independent life that can be shaped largely free of the dependency of other people. The exchange with other people of short stature can also be helpful in order to strengthen each other or to receive important information and tips. Basically, it can be beneficial not to see short stature as a decision criterion for a fulfilling life.

Short Stature