Clinical Pediatric Endocrinology
Online ISSN : 1347-7358
Print ISSN : 0918-5739
ISSN-L : 0918-5739
Poster Session
Stunted Growth and Hypothalamic-Pituitary Dysfunction before and after Eating Disorders in Children and Adolescents
Reiko HorikawaShoko IkemaNorimasa Ikuta
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2005 Volume 14 Issue Supplement24 Pages S24_59-S24_62


The increasing frequency and the younger onset of eating disorder is becoming a social problem in Japan. The diagnostic criteria of anorexia nervosa according to DSM IV include weight loss and amenorrhea, however, it does not include "no or low weight gain" and "stunted growth" in growing children and adolescents. In this study, we analyzed the growth and endocrine function in 45 patients (39 females and 6 males) with anorexia nervosa. The age at the onset of disease (the onset of weight loss) varied from 10 to 16 yr old. When plotting the changes of height and weight in each individual on the growth chart for Japanese children, 8 out of 45 showed decreased or no weight gain before the apparent onset of weight loss, for more than two years. The stunted growth was associated with decreased weight gain. Endocrine function was tested in 36 patients. Approximately half of the children and adolescents showed exaggerated growth hormone response to provocative tests, while the rest showed low growth hormone levels. Gonadotrophins and thyrotropin responses to LHRH and TSH stimulation were decreased in most of the cases tested. About 80% of the patients recovered from the critical weight loss, but the recovery of height is not always successful. In conclusion, eating disorders with severe weight loss in growing children sometimes result in irreversible growth failure. Plotting the growth chart is helpful for finding the "true" onset of eating disorder.

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© 2005 by The Japanese Society for Pediatric Endocrinology
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