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Gepubliceerd in: Tijdschrift voor Kindergeneeskunde 1/2014

01-01-2014

Genetische oorzaken van kleine lengte

Auteurs: Mw. dr. Sarina G. Kant, Mw. dr. Marie-José Walenkamp

Gepubliceerd in: Tijdschrift voor Kindergeneeskunde | Uitgave 1/2014

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Samenvatting

De volwassen lengte wordt voor het grootste deel bepaald door genetische factoren. Veel van deze factoren hebben een klein effect op de lengtegroei. In het diagnostisch proces bij een groeiachterstand is het vooralsnog alleen mogelijk onderzoek te doen naar de erfelijke factoren die juist een groot effect hebben. Alvorens hiertoe over te gaan, is het van belang om via anamnese, familieanamnese, lichamelijk onderzoek en eventueel radiologisch onderzoek de groeiachterstand goed te karakteriseren. Daarbij is het van belang te letten op lichaamsproporties, op dysmorfe kenmerken en/of aangeboren afwijkingen en op het begin van de groeiachterstand (preof postnataal). Bij afwijkende lichaamsproporties (met name korte ledematen ten opzichte van de romp) bestaat er een verdenking op een skeletdysplasie, bij dysmorfe kenmerken en/of aangeboren afwijkingen moet een syndromale oorzaak van kleine lengte worden overwogen, terwijl bij een laag gewicht of kleine lengte bij de geboorte, zonder inhaalgroei, aandacht moet worden besteed aan IGF-I en de IGF-I-receptor. Vanwege het belang van een diagnose voor prognose en mogelijke therapie kan bij blijvende onduidelijkheid over de oorzaak van de kleine lengte de expertise gevraagd worden van een speciale polikliniek of (internationale) werkgroepen. Als ook dan de diagnose niet kan worden gesteld, is het zinvol het kind na een aantal jaren terug te zien en de groei opnieuw te analyseren, omdat er nieuwe syndromen dan wel nieuwe inzichten in bestaande aandoeningen kunnen zijn beschreven, maar ook vanwege de voortschrijdende vernieuwing van onderzoekstechnieken.
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Metagegevens
Titel
Genetische oorzaken van kleine lengte
Auteurs
Mw. dr. Sarina G. Kant
Mw. dr. Marie-José Walenkamp
Publicatiedatum
01-01-2014
Uitgeverij
Bohn Stafleu van Loghum
Gepubliceerd in
Tijdschrift voor Kindergeneeskunde / Uitgave 1/2014
Print ISSN: 0376-7442
Elektronisch ISSN: 1875-6840
DOI
https://doi.org/10.1007/s12456-014-0004-1