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Child Has Short Stature, Wrist Pain, Had Ganglion Cyst, Vision Problems. Would A Blood Test Determine The Problem?
Question: Our youngest daughter, who is 8 years old, is at the 10th percentile on her height. All of our other 4 children are average or above on height. My husband is 6 foot 3 and I am 5 foot 4. We believe it is possible that several years ago she took an adult antibiotic for an absessed tooth. None of our other children have ever had an absessed tooth. A couple of years ago, she started having lumps in her neck and the doctor said this was normal and a sign of infection. She does not currently have any neck lumps that I am aware of. A few months ago she started having lumps on her wrists and started complaining of wrist, neck, shoulder and heal pain. We took her to the doctor and he said that she had a ganglion cyst on one wrist and had strained the other wrist and gave her a wrist brace. He told her to take a break from turning cartwheels. She is very active and always turning flips, etc. Yesterday she told me her eyes have been bothering her. I covered one eye at a time and had her read letters to me. I noticed that when using her left eye in particular, she squinted and called a capital D an O, and a capital E and F. This is the first time I have been aware of her having any vision problems. I am concerned that all of these things might be related. Would a blood test determine if there is something to be concerned about? She does seem to have plenty of energy and her appetite is fine, but yet she complains a lot that she hurts. Our other children have been very healthy for the most part and they don't normally ever have to go the doctor other than for routine checkups.
Dear friend,
Looking at all the historical details that you have so kindly provided in such amazing detail and with lucidity that is unusual for a non-medical parent, I am prompted to think that perhaps you are right. The illness that may link her body pains, eye trouble, the glands that she had in her neck etc. may belong to the category of auto-immune diseases. However, the time frame that links all the symptoms is a bit too long for it to fit any one particular entity. This group of diseases are also referred to as immune or rheumatic illnesses and the science encompassing them is called Rheumatology. This is quite different from the "rheumatism" that is seen in the elderly. There are over 20 entities that have symptoms from among those you have mentioned in the question, including rheumatic arthritis, lupus, etc. but I am a little wary to confirm this for you over the net.
What you need to do is to first visit her pediatrician, and if he/she feels the same way as I do, you might want to ask him/her to refer you to a pediatric rheumatologist for further appraisal and the ordering of specialised investigations. This may also entail her visiting an ophthalmologist to discover why she is facing visual problems of late.
Having said all this, I must also say that this consultation being in "absentia", I may be totally wrong about my intuition, and perhaps she may NOT have any systemic illness. In which case, as you might have already guessed, there is no problem and she would probably only need glasses for her vision and symptomatic care for her other problems.
As to the RSI (repetitive stress injury) manifested by the lumps that she has had over the wrists, she may have to seek help from a sports/fitness doctor who would tailor her future sports freedom/restrictions, in addition to providing care for the problem already present.
I hope this clarifies the problem to some extent. If need be, you may contact me again for further guidance.
With best wishes and a prayer for the most favourable outcome for your precious one,
Dr. Taher
Looking at all the historical details that you have so kindly provided in such amazing detail and with lucidity that is unusual for a non-medical parent, I am prompted to think that perhaps you are right. The illness that may link her body pains, eye trouble, the glands that she had in her neck etc. may belong to the category of auto-immune diseases. However, the time frame that links all the symptoms is a bit too long for it to fit any one particular entity. This group of diseases are also referred to as immune or rheumatic illnesses and the science encompassing them is called Rheumatology. This is quite different from the "rheumatism" that is seen in the elderly. There are over 20 entities that have symptoms from among those you have mentioned in the question, including rheumatic arthritis, lupus, etc. but I am a little wary to confirm this for you over the net.
What you need to do is to first visit her pediatrician, and if he/she feels the same way as I do, you might want to ask him/her to refer you to a pediatric rheumatologist for further appraisal and the ordering of specialised investigations. This may also entail her visiting an ophthalmologist to discover why she is facing visual problems of late.
Having said all this, I must also say that this consultation being in "absentia", I may be totally wrong about my intuition, and perhaps she may NOT have any systemic illness. In which case, as you might have already guessed, there is no problem and she would probably only need glasses for her vision and symptomatic care for her other problems.
As to the RSI (repetitive stress injury) manifested by the lumps that she has had over the wrists, she may have to seek help from a sports/fitness doctor who would tailor her future sports freedom/restrictions, in addition to providing care for the problem already present.
I hope this clarifies the problem to some extent. If need be, you may contact me again for further guidance.
With best wishes and a prayer for the most favourable outcome for your precious one,
Dr. Taher
Above answer was peer-reviewed by :
Dr. Aparna Kohli
Thank you Dr. Taher for your kind and prompt reply. Thank you for your suggestions. As parents taking our child to the doctor, we never want to come across as being dramatic or to be over-reacting to her symptons. But yet, if there is something serious wrong, I want it to be discovered in a timely manner, so that we can start treatments and preventions. My prayer is that she is just experiencing normal pains from being very active and that the eye problems are just that and not a symptom of something else. Also, I wanted to say that I mis-stated when I said we think she was given an adult anitbiotic. We know that she was given several doses of an adult antibiotic in pill form that was divided down to a smaller milligrams and crushed and put into XXXXXXX sauce for her to take when she had the absess. I have since then heard some antibiotics can cause stunting of growth and this has concerned me that it is possible that the particular anitbiotic she had might have had that side effect and that is why she is so small compared to the rest of the family. The antibiotic was given to my husband at a free Native American clinic and we have not been able to attain records to let us now what the name of the anitbiotic was.
Hi,
Thans for writing back.
Generally speaking, antibiotics are not known to affect the growth of a child. The only class of antibiotics that are not recommended for children below the age of 8 years are 'tetracyclines' and this is because they affect the growth and maturation of the unerupted secondary teeth; children exposed to tetracyclines before the age of 8 years are likely to have disfigured, yellow-stained teeth after the milk-teeth have fallen off. Aside of this, there is a newer group of anti-bacterial drugs called the fluoro-quinolones, which have been shown to cause damage to the growing cartilage of bones in experimental baby-animals. Fortunately, the same problem does not seem to occur in humans, even when they are used in infants.
Leaving these two classes of drugs, most antibiotics are safe from the point of view of their effect on body growth. Hence, for all practical purposes, you should rest your mind about this anxiety.
Having said this, let me point out that most cases of failure to grow turn out to be constitutional delay of growth, which tends to remain so, or some kind of genetic problem - which does not seem to be the case with your child. One of the initial tests carried out by doctors is taking X-rays of the hand of a child suspected to have growth failure and seeing the growth of the bones of the wrist and hand and comparing them to standardised X-rays of the growth progress seen in children of every age group from birth to adolescence. If the child's bone growth is less than her actual age, we call it retarded bone age, and if normal, we look for other causes of failure to grow. Based on the interpretation of the growth of the bones of the hand and wrist, the pediatrician then classifies the child into one of the two groups: child with normal bone age and child with retarded bone age.
The first group has the child with constitutional growth failure, while children with familial growth failure, endocrine problems and so on will fall into the second group.
Thus, a proper understanding of the cause of your child's growth retardation is only possible if bone age is determined.
Thank you for staying with me. Do keep in touch.
- Dr. Taher
Thans for writing back.
Generally speaking, antibiotics are not known to affect the growth of a child. The only class of antibiotics that are not recommended for children below the age of 8 years are 'tetracyclines' and this is because they affect the growth and maturation of the unerupted secondary teeth; children exposed to tetracyclines before the age of 8 years are likely to have disfigured, yellow-stained teeth after the milk-teeth have fallen off. Aside of this, there is a newer group of anti-bacterial drugs called the fluoro-quinolones, which have been shown to cause damage to the growing cartilage of bones in experimental baby-animals. Fortunately, the same problem does not seem to occur in humans, even when they are used in infants.
Leaving these two classes of drugs, most antibiotics are safe from the point of view of their effect on body growth. Hence, for all practical purposes, you should rest your mind about this anxiety.
Having said this, let me point out that most cases of failure to grow turn out to be constitutional delay of growth, which tends to remain so, or some kind of genetic problem - which does not seem to be the case with your child. One of the initial tests carried out by doctors is taking X-rays of the hand of a child suspected to have growth failure and seeing the growth of the bones of the wrist and hand and comparing them to standardised X-rays of the growth progress seen in children of every age group from birth to adolescence. If the child's bone growth is less than her actual age, we call it retarded bone age, and if normal, we look for other causes of failure to grow. Based on the interpretation of the growth of the bones of the hand and wrist, the pediatrician then classifies the child into one of the two groups: child with normal bone age and child with retarded bone age.
The first group has the child with constitutional growth failure, while children with familial growth failure, endocrine problems and so on will fall into the second group.
Thus, a proper understanding of the cause of your child's growth retardation is only possible if bone age is determined.
Thank you for staying with me. Do keep in touch.
- Dr. Taher
Above answer was peer-reviewed by :
Dr. Aparna Kohli
Thank you so much for your detailed reply, as I know your time is valuable. You have relieved a burden I have had about the antibiotics for several years. Although I am about average height and my husband is above average in height, I do have shortness on my side of the family. My mother is 5'1" and her mother was under 5 feet. It is possible that my daughter XXXXXXX inherited this. That is fine as we love her just as she is, but I had worried that we had done something that had caused her not to grow as she had been intended. Also, she had some problems with her baby teeth, but her permanent teeth are coming in beautifully and look nice. i am going to make an appointment for her tomorrow to address all of the concerns I have. You have been a huge help and I feel that I have gotten many questions answered that I've had for a long time. Thank you so much! XXXXXXX
P.S. On a brighter note, our oldest son (age 17) tied for 3rd place in a junior golf tournament today that had about 200 participants. I am a proud mommy of all of my children. If you want to view my family on facebook, including the daughter I have been concerned about, you will find me under XXXXXXX
P.S. On a brighter note, our oldest son (age 17) tied for 3rd place in a junior golf tournament today that had about 200 participants. I am a proud mommy of all of my children. If you want to view my family on facebook, including the daughter I have been concerned about, you will find me under XXXXXXX
Dear XXXXXXX
It was a pleasure for me to be able to help you. I am registered on FB as Taher Kagalwala. I am the guy in a black tee with sun-glasses. Feel free to visit my profile at www.facebook/drtaher.
Dr. Taher
It was a pleasure for me to be able to help you. I am registered on FB as Taher Kagalwala. I am the guy in a black tee with sun-glasses. Feel free to visit my profile at www.facebook/drtaher.
Dr. Taher
Note: For further queries related to your child health, Talk to a Pediatrician. Click here to Book a Consultation.
Above answer was peer-reviewed by :
Dr. Shanthi.E
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