Abstract
Psychosocial Dwarfism (PSD) is a syndrome of severe growth failure in an abnormal home environment with a hostile or a depriving parent. We studied an 8 yr. old boy with PSD. While in the hospital after an initial 3 week period of poor growth he demonstrated rapid catch-up growth (growth velocity 3 cm/month). During the period of poor growth the mean caloric intake was 1663 cal/day, in the period of catch-up growth it was 1515 cal/day. The maximum stimulable growth hormone (GH) was 5.9 ng/ml initially and 13.6 ng/ml during rapid growth. SM was normal (0.79 and 0.84 U/ml) in both periods. While under continued observation, with separation from his favorite nurse, his growth velocity dropped to 0.5 cm/month, but there was no change in his stimulable GH or SM. The caloric intake remained unchanged at 1504 cal/day. With the return of his favorite nurse he resumed his pre.ious growth velocity 01 3 cm/ month and caloric intake during this period was 1521 cal/day. Again GH and SM were normal. He returned to his depriving home and growth velocity decelerated again to 0.4 cm/month, SM acitvity remained normal at 0.91 U/ml. We conclude from these data that growth failure in this patient with PSD is not due to caloric under-nutrition nor to defective GH release or SM generation, but to an as yet unidentified factor inhibiting growth during emotional stress.
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Saenger, P., Levine, L., Wiedemann, E. et al. Psychosocial dwarfism: Normal Somatomedin (SM). Pediatr Res 9, 677 (1975). https://doi.org/10.1203/00006450-197508000-00077
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DOI: https://doi.org/10.1203/00006450-197508000-00077