GROWTH CHART

1. Growth chart

13. abnormalities
• Case 1
• Ali 4 months old with a weight
of 4 kg and height of 62 cm , h.c
42 cm.

14. Weight below 5 th centile

15. causes
• - under nutrition
• -hypothyroidism
• -iron deficiency
• -chronic systemic disease ( GIT ,
RESP, RENAL ,CARDIAC )
• -INBORN ERROR OF
METABOLISM

16. Marasmus
• Marasmus is a
form of
malnutrition. It
happens when
the intake of
nutrients and
energy is too low
for a person's
needs.

17. Hypothyroid

18. congenital hypothyroidism?
Congenital hypothyroidism (CHT) is a
condition resulting from an absent or
under-developed thyroid gland
(dysgenesis)

19. symptoms
• sleepy
• difficult to feed
• prolonged jaundice
• constipation
• cold extremities
• poor growth

20. Untreated, CHT can result in impaired brain
development

21. Case 2
• Lulu 6 months old with a weight
of 10 kg ,
• Ht 65 cm , Hc 42 cm

22. Weight above 95th centile

23. causes
• Endocrine causes :
• - hypothyroid
• - Excess cortisol
production ( cushing disease )
• Genetic disorders :
• - Down syndrome
• - Prader willi syndrome
• Over feeding

24. Down
syndrom

25. • Down syndrome is a genetic disorder caused when
abnormal cell division results in an extra full or partial
copy of chromosome 21
• Trisomy 21

26. features
• Flattened face
• Small head
• Short neck
• Protruding tongue
• Upward slanting eye lids (palpebral fissures)
• Unusually shaped or small ears
• Poor muscle tone
• Broad, short hands with a single crease in the
palm
• Relatively short fingers and small hands and
feet
• Excessive flexibility
• Tiny white spots on the colored part (iris) of
the eye called Brushfield's spots
• Short height

27. Cushing’s
syndrom

28. Praderwilli
syndrom

29. ?
• Prader-Willi syndrome is
caused by a genetic defect on
chromosome number 15
• The symptoms of Prader-Willi
syndrome are likely due to
dysfunction of the hypothalamus.

30. symptoms
• Early Life
• hypotonia or “floppy”.
• weak cry and a poor suck reflex
• delayed Motor milestones.

31. • Childhood
• Unregulated appetite and easy
weight gain
• IQs ranging from low normal to
moderate intellectual disability
• growth hormone
deficiency/short stature
• small hands and feet, scoliosis.

32. Case 3
• Fajer 5 years old with weight 23
kg , height 125 cm , Hc 53 cm

33. Height > 95th centile

34. causes
• Obesity
• Excess GH production
• Hyperthyroid
• Syndromes
• - Klinefelter $
• - marfan $

35. Klinefelter $

36. Signs

37. Marfan $

38. Marfan $
genetic disorder of
the connective tissue
autosomal dominant

39. symptoms
• Tall .
• Disproportionately long arms,
legs and fingers
• A breastbone that protrudes
outward or dips inward
• A high, arched palate and
crowded teeth
• Heart murmurs
• An abnormally curved spine
• Flat feet

41. Case 4
• Fatma 7 years old with
• Weight 25 kg
• Ht 105 cm

42. Ht < 5th centile

43. causes
• GH deficiency
• Hypothyroid
• Chronic anaemia
• Chronic systemic disease ( GIT ,
Renal , Resp, CVS ).
• Rickets
• Chromosomal disorder ( turner $
)

44. Turner $

45. • Turner $

47. • Turner syndrome, a condition that affects only
females, results when one of the X chromosomes
(sex chromosomes) is missing or partially missing

48. symptoms
•
Low-set ears
• Broad chest with widely spaced nipples
• Arms that turn outward at the elbows
• Fingernails and toenails that are narrow
and turned upward
• Swelling of the hands and feet,
especially at birth
• Slowed growth
• Cardiac defects
• Low hairline at the back of the head
• Short fingers and toes

49. Case 5
• Mina 6 months old boy with
weight 7 kg , ht 65 cm
• Hc 49 cm

50. ?
•HC > 95th centile

51. causes
• benign familial macrocephaly.
• Rickets
• Hydrocephalus – obstructive or communicating

52. • Genetic
• Autism spectrum disorder
• Bone dysplasia – achrondroplasia
• Fragile X –
• Neurocutaneous disorders –
neurofibromatosis, tuberous sclerosis
• Storage diseases
• ( mucopolysacharidosis )

53. hydrocephalus

54. neurofibromatosis

56. neurofibromatosis
• Neurofibromatosis type
1 (NF1) and type 2
(NF2) are
neurocutaneous
disorders inherited as
autosomal dominant
genetic syndromes

57. symptoms
• Presence of (café-au-lait) on the skin.
• Appearance of two or more neurofibromas (pea-
sized bumps
• freckles under the armpits or in the groin areas.

58. mucopolysaccharidosis

59. • The mucopolysaccharidoses (MPS) are lysosomal
storage disorders
• All of the MPS are autosomal recessive disorders,
with the exception of MPS II, which is X linked.

60. symptoms
• Hepatosplenomegaly
• Corneal clouding
• Cardiac involvement, valve disease
• Skeletal dysplasia
• Growth delay
• Profound neurological involvement (in the severe form
only)
• Macrocephaly

61. CASE 6
• ALI 1.5 YEARS OLD BOY
• WEIGHT 13 KG
• HEIGHT 85 CM
• HC 45 CM

62. • H.C < 5TH centile

63. CAUSES
• CRANIOSYNOSTOSIS
• Prenatal insult
• - TORCH infection
• - maternal drugs or alcohol abuse.
• Chromosomal abnormalities
• trisomy 18 , trisomy 13