Growth hormone deficiency in children

Growth hormone deficiency means the pituitary gland does not make enough growth hormone.


The pituitary gland is located at the base of the brain. This gland controls the body’s balance of hormones. It also makes growth hormone. This hormone causes a child to grow.
Growth hormone deficiency may be present at birth (congenital). Or it may be the result of medical condition. Severe brain injury may also cause growth hormone deficiency.
Children with physical defects of the face and skull, such as cleft lip or cleft palate, may have decreased growth hormone levels.
Most of the time, the cause of growth hormone deficiency is unknown.

Symptoms
Slow growth may first be noticed in infancy and continue through childhood. The pediatrician will usually draw the child's growth curve on a growth chart. Children with growth hormone deficiency have a slow or flat rate of growth. The slow growth may not show up until a child is 2 or 3 years old.
The child will be much shorter than most children of the same age and gender. The child will still have normal body proportions though body build may be chubby. Often the child’s face looks younger than children of the same age. The child will usually have normal intelligence.
In older children, puberty may come late or may not come at all, depending on the cause.

Exams and Tests
A physical examination, including weight, height, and body proportions, will show signs of slowed growth rate. The child will not follow the normal growth curves.
Hand x-ray can determine bone age. Normally, the size and shape of bones change as a person grows. These changes can be seen on an x-ray and usually follow a pattern as a child grows older.
Testing is usually done after the  pediatrician has looked into other causes of poor growth. Tests that may be done include:
Growth hormone causes the body to make insulin-like growth factor (IGF1) and insulin-like growth factor binding protein 3 (IGFBP3). Tests can measure these growth factors.Accurate growth hormone deficiency testings involves a stimulation test. This test takes several hours.
MRI of the head can show the hypothalamus and pituitary glands.
Tests to measure other hormone levels may be done because lack of growth hormone may not be the only problem.

Treatment
Treatment involves growth hormone shots (injections) given at home. The shots are usually given once a day. Older children can often learn how to give themselves the shot.
Treatment with growth hormone is long-term, often several years. During this time, the child needs to be seen regularly by the doctor to ensure treatment is working and to change the dosage of the medicine if needed.
Serious side effects of growth hormone treatment are rare. Common side effects include:

    Headache
    Fluid retention
    Muscle and joint aches
    Slippage of the bones at the hip

The earlier the condition is treated, the better the chance that a child will grow to near-normal adult height. Many children gain 4 or more inches over the first year and 3 or more inches during the next 2 years. The rate of growth then slowly decreases.

Urinary Tract Infections in Children

As many as 8 percent of girls and 2 percent of boys will develop a urinary tract infection. Furthermore, young children have a greater risk of kidney damage linked to urinary tract infection than older children or adults. The information below should help you recognize a urinary tract infection in children before it causes serious damage.

What causes urinary tract infections in children?

Normal urine is sterile and contains no bacteria. However, even under normal circumstances bacteria cover the skin and are present in large numbers in the rectal area and within bowel movements. Bacteria may, at times, get into the urinary tract and travel up the urethra into the bladder. When this happens, the bacteria multiply and unless the body gets rid of the bacteria, they can cause infection (urinary tract infection or "UTI."

There are two general types of UTIs—bladder infection and kidney infection. When the infection involves the bladder it can cause inflammation, swelling and pain of the bladder. This is called cystitis. If the bacteria travel upward from the bladder through the ureters and reach and infect the kidneys, the kidney infection is called pyelonephritis. Kidney infections are more serious than bladder infections, and can cause kidney damage especially in young children.

What are the symptoms of urinary tract infections in children?

Most often when there is a urinary tract infection, the linings of the bladder, urethra, ureters, and kidneys become red and irritated. This usually causes painful, frequent urination and children may pass urine with a foul odor. Many children start having urinary accidents, and/or bloody urine. If the kidneys become infected, children often have abdominal or back pain and fever. If your child is an infant or too young to tell you how he or she feels, the signs are likely to be vague and unrelated to the urinary tract. For example, your child may just have a high fever, or be irritable and not eating, or sometimes have only a low-grade fever, loose bowel movements or just not seem healthy. You may notice that the diaper urine "smells bad." If your child has a high temperature and appears sick without another obvious source for his/her discomfort (such as runny nose or ear ache), they should see a doctor. If a kidney infection is not treated promptly, the bacteria may spread to the bloodstream and cause a life-threatening infection or permanent kidney damage.

Older children may complain of pain in the low stomach area or back as well as the need to urinate frequently. Your child may cry when he or she urinates or complain that it hurts to urinate and produce only a few drops of urine. It may be hard for them to control their urine so they may have urinary accidents or bed-wetting. They may also produce urine that smells bad or looks cloudy.

How are urinary tract infections treated in children?

Urinary tract infections are treated with antibiotics. If your doctor thinks your child has a urine infection, they will choose a drug that treats the bacteria most likely to be causing the problem. Sometimes a few days later, after the culture results are finished, the antibiotic drug might be changed to one that is more effective against the particular bacteria found in your child's urine. In addition to antibiotics, you can help your child's body fight the infection by encouraging lots of fluids and very frequent urination.

The specific antibiotic drug, way it is given and number of days that it must be taken may depend, in part, on the type and severity of infection. If your child is very sick and unable to take fluids, the antibiotic may need to be given as shots (injected directly into the bloodstream or muscle) with your child in the hospital; otherwise, oral medicine may be given. The daily treatment schedule your child's doctor recommends will depend upon the specific drug prescribed: it may call for a single dose each day or up to four daily doses. In some cases you will be asked to give your child medicine until further tests are finished.

After a few doses of the antibiotic, your child may appear much improved or even have returned to their normal activities, but often it may take weeks before all symptoms are gone. Even if they are improved, it is important that your child take the antibiotic medicines as prescribed by your doctor and not stop them because just because the symptoms have gone away. Unless urinary tract infections are fully treated, they may return, or your child may get another infection.

Primary Immunodeficiency Diseases

One of the most important functions of the immune system is to protect us from bacteria, viruses, and fungi that can make us sick. Not all organisms are harmful--in fact, our intestines contain many bacteria that help prevent problems such as allergies and improper absorption of nutrients. The immune system identifies the difference between what is dangerous and what is not and prevents whatever is dangerous from harming us. Primary immunodeficiency diseases (PIDDs) are caused by mutations in genes that prevent the body from developing normal immune responses to infectious challenges. The mutations can either be inherited or appear randomly.  Because the immune system is compromised in PIDDs, harmful organisms usually cause recurrent and sometimes life-threatening infections.  In addition, since these diseases are genetic, they are generally considered to be lifelong conditions once they are diagnosed.

How common are primary immunodeficiency diseases?

The most common PIDD is selective IgA deficiency, which has been reported as frequently as about one in every 300 to 400 individuals in the United States.  Although other PIDDs may occur less frequently, the actual rates of occurrence are not known because positive diagnoses are often not made.  As screening of newborns for important PIDDs becomes implemented as a standard practice, these statistics should become more accurate.

What are the signs and symptoms of primary immunodeficiency diseases?

Signs and symptoms that often alert us of the possibility of a PIDD are well-summarized by the following "10 Warning Signs of Primary Immunodeficiency":

    Four or more new ear infections within one year, particularly after the first year of life.
    Two or more serious sinus infections within one year.
    Two or more months on antibiotics with little effect.
    Two or more pneumonias within one year.
    Failure of an infant to gain weight or grow normally.
    Recurrent, deep skin or organ abscesses.
    Persistent thrush in the mouth or significant fungal infections on the skin.
    Need for intravenous antibiotics to clear infections.
    Two or more deep-seated infections, including infections of the bloodstream.
    A family history of primary immune deficiency.

How are primary immunodeficiency diseases treated?

Our patients are often given antibiotics or antifungal medications for prevention or treatment of infections. These medications need to be prescribed carefully because they can sometimes cause unwanted side effects or encourage the growth of bacteria that are resistant to antibiotics. Patients who lack the ability to make antibodies often require immunoglobulin replacement therapy.  Some patients, depending on the type of PIDD that has been diagnosed, may require bone marrow or umbilical cord stem cell transplantation or even thymus transplantation in the most severe cases. Sometimes it may be treated with anabolic steroids.

Nutrition And Immunity In Children

Often in first signs of cold parents complain on weak immunity of child imagining badly what signs of illness exactly should cause anxiety. Does your child get diseased with influenza 3 – 4 times a year?

Most likely, in this case there is no need to worry and interfere with process of immunity formation in child. As general strengthening procedures may be recommended cold training of the body, walkings on fresh air and in children over 3 years old taking of natural botanical medicines based on Echinacea juice.

Day regimen
When sleep, rest, exercises, studies, work and food intake occur at one and the same time, then for the body it is easier to turn from one activity to another and there is consumed much less energy. Rhythmic cycle helps the body to effectively recuperate, optimally react on stress and changes, therefore child with an accurate and cozy regimen has more capabilities to meet an attack of bacteria and viruses.

Nutrition
First of all, for adequate development child should consume animal proteins and fats. For cold prevention it is good to eat onion and garlic – natural products containing phytoncides - and also vegetables, fruits and berries of red, orange and green color which do contain great amount of vitamin C.

It is better to avoid flavor enhancer, colorants and synthetic vitamins because they do give an additional load on body systems, provoke allergic reactions and do overload child's immunity because they are taken for a long time without taking into consideration individual needs.

Sugar also overloads immune system, helps to wash away from the body all vitamins and microelements and it would be better to exclude it from baby foods. It is good when meals take place at one and the same time as this helps body to better digest foods.

Children's Immunity

One of most important tasks of all parents is care about strengthening their children's immunity because immunity is the base of human health throughout the whole life from birth to decay.

In order to find out how to develop and strengthen child's body defences it is necessary to know nature and mechanisms of immunity. Immunity is the ability of body to effectively resist the action of foreign microorganisms, for example, viruses and bacteria that cause infectious diseases.

There are two types of immunity:

• specific immunity that develops after past diseases, for example, rubella or measles. This immunity type may be developed for the whole life or for some time depending on the disease.
• non-specific immunity that develops in a baby during pregnancy.

From mother's breast milk child gets antibodies to infectious disease which mother had. It means that child on breast feeding has passive immunity and this is very important in first months of life because in this period proper immune system only starts working. 

Therefore, when mother gets cold she needs to continue to feed child with her breast to give antibodies to baby. WHO recommends to feed baby up to two years or even more. Growth factors presented solely in female milk help baby's immune system develop normally.
 

Bifidus factor and lactoferrin presented in mother's milk do increase healthy bifido and lactic bacteria in bowels and reduce growth of pathogenic flora which strengthens child's immunity and lowers liability to colds. Breast feeding cannot 100% guarantee no diseases, but healthy gastrointestinal tract and calm emotional atmosphere in family lower likelihood of getting sick.

How To Protect Your Children From Influenza?

When a man is diseased with influenza virus, almost all body systems are damaged including immune system, that is why recovered children feel weak and vulnerable to different viruses and bacterial infections. In order to lower disease incidence it is recommended to vaccinate not only children but also their parents.

In children from 6 months to 2 years with influenza virus, there is a high probability of complications influencing on cardiovascular and even nervous systems. According to research data, 40% of children of that age have complications with otitis, which often leads to deafness. New-born children diseases with influenza virus are subjected to complications.

Vaccination of children from 3 to 17 years is also necessary because children in this age often get diseased with influenza. Besides, children of that age are major spreaders of the virus which increases the risk of parents to get diseased.

The effectiveness and safety of vaccine

Vaccination practically has no contraindications but when choosing a vaccine you should consult your doctor. The effectiveness of vaccination in children is 70-100%. In children up to 6 months vaccination is less effective because of freshness of their immune system, so it is recommended to vaccinate pregnant women in second or third Trimester.

How to make a vaccine?

In order to get vaccinated you should go in one of vaccinating centers, or you can buy vaccine and use it by yourself.