Etiology of short stature in east Azerbaijan, Iran

Short stature is a common problem encountered by pediatricians and is the most common cause for referral to pediatric endocrinologists. Although most children referred with short stature are normal and classified as normal variants of stature [constitutional growth delay and familial short stature], it may sometimes be the only obvious manifestation of an endocrine or systemic disease. The objective of this study was to assess the characteristics of patients referred to pediatric endocrinology clinic because of short stature and determination of the etiology. Three hundred-seventy nine children and adolescents were studied which referred with short stature to pediatric endocrinology clinic. After complete clinical and paraclinical evaluation and appropriate treatment [if needed], patients were followed for at least six months. From 379 studied patients with a mean age of 9.7 +/- 3.7 years, 192 [50.7%] were girls and 187 [49.3%] boys [P=0.066]; short stature in 132 [34.8%] of patients was not approved. Normal variants of Short stature [familial and constitutional] constituted 53.3% of etiology in short patients. In 11.5% of short patients, no obvious etiology was found, and 9.8% were born with intra uterine growth retardation. Other causes were growth hormone deficiency, hypothyroidism, skeletal dysphasia, Turner syndrome, and malnutrition. A great number of children and adolescents referred with short stature to pediatric endocrinology clinics are not really short. Greater than half of short patients are normal variants of Short stature

Severe neonatal hypercalcemia due to primary hyperparathyroidism; a case report

Neonatal primary hyperparathyroidism [NPHP] is a rare disease characterized by marked hypercalcemia, diffuse parathyroid hyperplasia and skeletal demineralization. These patients have symptoms of chronic hypercalcemia such as failure to thrive, irritability, abdominal pain and anorexia. It is often fatal unless parathyroidectomy is performed. Treatment with drugs usually is inadequate and often results in chronic hypercalcemia and death. A 10-day-old, 2.9 kg male newborn was hospitalized for anorexia, poor feeding, cyanosis, hypotonia, lethargy and severe dehydration. Diagnosis of severe hypercalcemia due to primary hyperparathyroidism was established and surgical approach selected because of failure of medical therapy to control hypercalcemia. The baby was successfully treated by total parathyroidectomy with autotransplantation. Although neonatal primary hyperparathyroidism [NPHP] is a rare disease, it must be considered for differential diagnosis in neonates with severe hypercalcemia. Early diagnosis and total parathyroidectomy with autotransplantation can be life-saving