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Published online August 1, 2005
PEDIATRICS Vol. 116 No. 2 August 2005, pp. e229-e234 (doi:10.1542/peds.2004-2830)
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ELECTRONIC ARTICLE

Growth Characteristics of Children With Ectodermal Dysplasia Syndromes

Kathleen J. Motil, MD, PhD*, Timothy J. Fete, MD, MPH{ddagger}, J. Kennard Fraley, MPH*, Rebecca J. Schultz, RN, CPNP§, Thomas M. Foy, MD{ddagger}, Ulrike Ochs, MD||, Virginia P. Sybert, MD

* Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, Texas
{ddagger} Department of Pediatrics, St Louis University, St Louis, Missouri
§ Department of Pediatrics, Baylor College of Medicine, Houston, Texas
|| Division of Dermatology, Virginia Mason Medical Center, Seattle, Washington
University of Washington and Group Health Permanente, Seattle, Washington

Objective.Clinical observations suggested that growth abnormalities may be present in children with ectodermal dysplasia (ED) syndromes. This study characterizes the longitudinal pattern of growth in a cohort of children with the ED syndromes. We hypothesized that (1) linear and ponderal growth abnormalities are present in children with ED from infancy through adolescence, and (2) linear and ponderal growth abnormalities differ among the clinical variants of these disorders.

Methods.We studied 138 children who had ED and were registered with the National Foundation for Ectodermal Dysplasias, 74% of whom had clinical features consistent with the hypohidrotic EDs (HEDs). Height (or length) and weight measurements were obtained by standardized techniques and from review of available medical records. We converted these measurements to weight-for-height (children younger than 5 years and <103 cm in length) or BMI (children ≥2 years old). Height, weight, weight-for-height, and BMI were converted to age- and gender-specific z scores. We applied linear regression, 1-sample t tests, and analysis of variance to detect linear and ponderal growth abnormalities in children with ED compared with a reference population.

Results.Mean weight-for-age, weight-for-height, and BMI-for-age z scores but not height-for-age z score, were significantly lower in children with the ED syndromes than in the reference population. Mean weight-for-age and weight-for-height z scores but not BMI-for-age or height-for-age z scores increased significantly with increasing age. The mean height-for-age z score of children with the ED syndromes other than the HEDs was significantly lower than that of children with the HEDs.

Conclusions.Growth abnormalities, measured as weight deficits, were present at an early age in children with the ED syndromes and persisted through adolescence. Height deficits were seen only in children with ED syndromes other than HEDs. Clinicians should evaluate carefully children with ED syndromes for growth abnormalities.

Key Words: height • weight • malnutrition • growth failure • failure to thrive • short stature

Abbreviations: ED, ectodermal dysplasia • HED, hypohidrotic ectodermal dysplasia • NFED, National Foundation for Ectodermal Dysplasias • EEC, ectrodactyly-ectodermal dysplasia-clefting syndrome • CI, confidence interval

Accepted Feb 4, 2005.


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