Final height of patients with congenital heart disease / 소아과

PURPOSE: Growth impairment is usually observed in children with congenital heart disease (CHD). Studies on the final height and weight of this population are insufficient. Our aim was to evaluate the final height of children with CHD and to identify the relationship between CHD and growth. METHODS: We recorded the values of final height and weights of 105 CHD patients (age, <19 years) who visited Chonnam National University Hospital between November 2000 and March 2009, and we reviewed the medical records. RESULTS: The mean values of weight and height of male CHD patients were significantly lower than those of the normal subjects. Patients with severe growth impairment (below the third percentile of normal) included 5 males (8.6%) and 4 females (8.5%) with height less than normal and 9 males (15.5%) and 8 females (17.0%) with weight less than normal. The mean growth of the patients in the cyanotic heart disease group was lower than that of normal subjects, but a statistically significant difference was noted in the weights of males. In a comparative study based on the type of CHD, a significant difference was noted in weights of males. Patients with patent ductus arteriosus and those with tetralogy of Fallot had the highest and lowest mean values of weight, respectively. CONCLUSION: Growth impairment was more evident in children with CHD than normal children. Patients should be treated during an optimal time frame. Thus, CHD patients should be treated if follow-up studies indicate growth impairment.

Final Height of Children after Stem Cell Transplantation

BACKGROUND: Growth impairment is a common complication after hematopoietic stem cell transplantation (SCT). The aim of this study was to evaluate the final adult height of patients who underwent SCT in childhood and to identify the factors that influence long-term growth in these patients. METHODS: A retrospective review of 15 children who underwent SCT before puberty at Chonnam National University Hospital and reached final adult height was undertaken. To assess the severity of height reduction and to monitor the height changes longitudinally, height measurements of each patient both at the time of SCT and the final height were expressed as the height standard deviation score (SDS). RESULTS: Seven children were males and eight were females with a median age of 12.8+/-2.4 years (range, 6.3~14.7) at SCT. The median follow-up period was 7.1+/-2.0 years (range, 4.5~11.1) and their final height was achieved at 18.1+/-1.5 years (range, 17.0~21.8). Final height SDS values were within normal for the healthy population in all except two who had short stature (below -2.0 SDS). No patient achieved height values greater than +2.0 SDS. The final height SDS value (-0.5+/-1.2) was not decreased from the height SDS value at SCT (-0.8+/-0.8). The younger age group at SCT (6.1~10.0 years, n=5) showed significantly lower final height SDS and greater Delta SDS than the older age group (10.1~15.0 years, n=10) (-1.5+/- 0.6 vs. -0.1+/-1.1, P.05) and the final height SDS (P<.05). The gender, type of disease, donor type or the presence of chronic graft-versus-host disease did not influence height. CONCLUSION: Growth impairment may be encountered in children after SCT. A younger age at transplant and irradiation were found to be factors associated with reduced final height. However, most patients (13/15) reached a final adult height within normal limits for the general healthy population.