Psychosociale deprivatie als oorzaak van groeivertraging bij kinderen

Patient A, a 3-year-old boy with short stature, in whom a partial growth hormone deficiency had been diagnosed, was treated with growth hormone. Further evaluation, however, showed that there was evidence of psychosocial deprivation as a result of an unstable family situation. After psychosocial circumstances improved, growth hormone therapy was discontinued, following which no further growth retardation was observed. In the case of patient B, a 10-year-old girl with short stature, reconstruction of the growth curve showed that growth stagnation had occurred around the age of 6 years. The cause was psychosocial deprivation during a severe illness in one of her triplet sisters. Following stagnation, there was insufficient compensatory growth, resulting in short stature. These cases emphasize the importance of reconstruction of the growth curve and of taking a thorough psychosocial case history in all children with growth retardation or small stature. The clinical picture of psychosocial growth retardation can be similar to the picture of idiopathic, isolated growth hormone deficiency. Prompt and accurate diagnosis prevents unnecessary, extensive investigations and enables adequate treatment and support.