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What Does My Health Check Up Report Indicate?

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Posted on Wed, 13 Sep 2017
Question: My son had his annual check up and the doctor said that his growth has slowed down. He's dropped to the 40th % range. His weight is fine. The doctor believes he's delayed, and wants to do a bone age test. I read the slowed growth can be due to kidney, heart, or digestive issues. My son has not had any of those issues with anybof these areas. He's 9 years old. 67lbs. 4ft 3 inches. His doctors says hes growing but slowly. He takes vyvanse for AD, and has a history of seizures. Hes been off the seizure medication for 2 years with no seizures in 4 years. Thoughts?
doctor
Answered by Dr. Pradeep Kumar Jain (42 minutes later)
Brief Answer:
There can be so many causes of delayed growth apart

Detailed Answer:
Hi

Thanks for asking on this platform

Growth delay is a very common complaint in children. It is usually assessed by plotting the growth pattern on standard chart.
The growth delay can be due to familial(genetic), constitutional(where child growth gets delayed for few years but the ultimate height is normal for age), nutritional or less commonly due to various diseases(chronic disease of kidney, lung, heart or liver). Another uncommon cause is growth hormone deficiency.
If there is growth delay as per standard growth chart then thorough assessment should be done. First step should be to see the height of parents and then chart the growth of child to find' Mid parental height'. This indicates that if parents are short heighted then there is high chance of child to become short.
Next step is bone age. To see other causes.
The most common cause is constitutional.
I suggest you to go as per your pediatrician advise for thorough investigation to find out the underlying cause.

I hope this helps.
Please let me know if you have any more questions.
Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Pradeep Kumar Jain (9 hours later)
Thanks for the infotmation. If my son had any kidneys or lung issues, would he potentaillyvhave others issues that would have been noticed or apparent?
doctor
Answered by Dr. Pradeep Kumar Jain (12 hours later)
Brief Answer:
Systemic diseases usually have symptoms

Detailed Answer:
Hi
Thanks for follow up

Systemic diseases involving renal, hepatic, heart or lung usually have symptoms which can sometimes be ignored by parents.
Like renal disease usually has symptoms like decreased or increased frequency of urine, swelling of body, low hemoglobin, rapid breathing etc. Similarly liver disease usually has abdominal distension, jaundice, low hemoglobin etc. Lung involvement usually presents with rapid breathing, chest in drawing, long duration cough, noisy breathing etc.
If you go to a pediatrician he would be able to catch any systemic disease by clinical examination in most of the cases.
So if there are no significant symptoms and also clinical examination is normal other causes which still remain there are genetic, constitutional, nutritional and some times growth hormone or thyroid abnormalities.

Regards

Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Pradeep Kumar Jain (8 minutes later)
Thanks. My son has not any of those issues. We watch his health closely due to past issues with siezures.
doctor
Answered by Dr. Pradeep Kumar Jain (12 hours later)
Brief Answer:
Seizure if controlled does not causes poor growth

Detailed Answer:
Hi

Seizure if it is controlled does not causes growth delay.
To me it appears to be more due to genetic or constitutional only.
Please get back to me with the reports once it is done.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Pradeep Kumar Jain (30 hours later)
We recvied the bone age test came in at 9 years old, and hes currenlty nine years old and 4 months.
Thoughts?
doctor
Answered by Dr. Pradeep Kumar Jain (5 hours later)
Brief Answer:
Bone age suggests familial short stature

Detailed Answer:
Hi

Thanks for follow up

Bone age that is almost equal to chronological (actual) age suggests it to be a familial short stature.
In constitutional, nutritional or poor growth due to chronic disease (renal, liver or lung) the bone age is usually less than actual age but it corresponds to the height age.
While in poor growth due to growth hormone or thyroid deficiency bone age is less than both actual age and height age.
So you need not to worry as chance of having underlying disease is almost nil.

Regards
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. Yogesh D
doctor
Answered by
Dr.
Dr. Pradeep Kumar Jain

Pediatrician, Cardiology

Practicing since :2006

Answered : 2074 Questions

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What Does My Health Check Up Report Indicate?

Brief Answer: There can be so many causes of delayed growth apart Detailed Answer: Hi Thanks for asking on this platform Growth delay is a very common complaint in children. It is usually assessed by plotting the growth pattern on standard chart. The growth delay can be due to familial(genetic), constitutional(where child growth gets delayed for few years but the ultimate height is normal for age), nutritional or less commonly due to various diseases(chronic disease of kidney, lung, heart or liver). Another uncommon cause is growth hormone deficiency. If there is growth delay as per standard growth chart then thorough assessment should be done. First step should be to see the height of parents and then chart the growth of child to find' Mid parental height'. This indicates that if parents are short heighted then there is high chance of child to become short. Next step is bone age. To see other causes. The most common cause is constitutional. I suggest you to go as per your pediatrician advise for thorough investigation to find out the underlying cause. I hope this helps. Please let me know if you have any more questions. Regards