Stature-weight growth delays: Clinical and etiological aspects.

Background: Stature-weight growth delay (SWGD) is a frequent motivation of consultation. It could be a consequence of a known chronic affection, congenital or acquired affection. The purpose of this study is to describe epidemiological, clinical, paraclinical, and etiological aspects of SWGD.

Patients and Methods: This retrospective study included 103 patients presenting a growth delay with an average age of 14.44 years and ranging between 5 and 21 years. Male predominance was noticed in 68.93% of cases. Patients showed a stature lower to -2 standard deviation (SD) for corresponding age compared to Sempe and Pedron reference. Patients were hospitalized in Endocrinology and Metabolic Diseases Department of the University Hospital of Fez, Fez, Morocco.

Results: Patient's history included a perinatal suffering in 6.7% of cases, a chronic pathology follow-up in 17.6% of cases, and psychomotor development disorder in 10.6% of cases. The average weight was -2.37 SD with extremes varying from -4 to -0.5 SD. The stature values varied between -4.5 and -2 SD for the given age, with an average of -3.12 SD. A severe stature delay (< -3 SD) was recorded in 39.6% of cases and the targeted average size was -2.44 SD with extremes varying from -4 to -1.5 SD. Growth delay etiologies were dominated by a deficit in growth hormones (GHs) in 60% of cases.

Discussion and Conclusion: Dynamic tests objectified a total deficit and partial deficits in GH in 41.7 and 30% of patients, respectively. The hypothalamo-pituitary magnetic resonance imaging was pathological in 23.3% of patients and showed a syndrome of interruption of pituitary stem in seven patients, pituitary hail gland in three patients, a craniopharyngioma in two patients, prolactin microadenoma in one patient, and nonfunctional pituitary microadenoma in one patient. GH treatment was established in 16 children that were presenting a deficit in GH, and two girls presenting Turner syndrome, whereas etiological treatment was suggested in all remaining cases.