Search

Child and Adolescent Obesity: WHAT ASSESSMENT? The prescription of laboratory tests or imaging in obese children and adolescents should be guided by the clinical features. It recognizes two main objectives: to eliminate a differential diagnosis (in particular, due to hypercorticism or hypothyroidism) and to detect the presence of comorbidities, assuming that some complications of obesity in adults can be sometimes present even in young age., Competing Interests: L’auteur déclare n’avoir aucun lien d’intérêts.

Background: Constitutional delay of growth and puberty (CDGP) is a frequent cause of short stature in childhood. Controversial results have been reported on the full achievement of these patients of their target height., Patients and Methods: The final adult height of 20 patients with CDGP (11 male and 9 female), who did not received hormonal treatment, was compared with their target height and with the predicted adult height, by the Bayley-Pinneau method obtained before the onset of puberty., Results: A spontaneous improvement of the stature from pre-puberty to adulthood was observed in all patients (from -2.9 +/- 0.7 SDS to -1.3 +/- 0.6 SDS in male and from -2.6 +/- 0.6 SDS to -0.9 +/- 0.3 SDS in female; P < 0.001). Adult height in male (166.4 +/- 4.1 cm) at the mean age of 21 years was very close to the target height (165.7 +/- 3.9 cm) and to the predicted adult height (167.3 +/- 3.1 cm). Also in female, final height (156.6 +/- 2.0 cm) did not differ from target height (153.3 +/- 4.2 cm) and from predicted adult height (155.6 +/- 2.3 cm)., Conclusions: In our experience, patients with CDGP reach their predicted adult height and achieve their genetic potential without medical treatment.

Background: Cases of diabetes mellitus associated with Turner syndrome are noninsulin-dependent. We report a case of insulin-dependent diabetes mellitus (IDDM) with Turner syndrome., Case Report: An 11 year-old girl with Turner syndrome was investigated for glucose tolerance that was normal with glycosylated hemoglobin at 5.1%. The patient was then given growth hormone plus oxandrolone until the age of 15 yr 3 mo; estrogen replacement was initiated at 15 yr 9 mo and progesterone 6 months later. At the age of 16.5 yrs, the patient developed manifestations of diabetes mellitus with polyuria, polydipsia, weight loss. Blood glucose concentration was 415 mg/dl with ketoacidosis. She was given insulin; at that time, blood insulin level was 7 mU/ml, C-peptide 0.8 ng/ml and glycosylated hemoglobin Alc 8.2%. Islet cell auto-antibodies were positive (1/80) and histocompatibility antigens were A1, A2, B14, B18, CW7, DR7, DR11, DQ7. After 6 months of treatment, blood insulin and C-peptide after IV glucagon were nil. There was no familial case of IDDM., Conclusions: This case of IDDM seems to be the first reported in Turner syndrome. This IDDM could be a manifestation of autoimmunity.