PEDIATRICS Vol. 78 No. 1 July 1986, pp. 124-132
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Prepubertal Growth and Skeletal Maturation in Children With Sickle Cell Disease

Michael C. G. Stevens MD, MRCP1, Gillian H. Maude BA, MSc1, Lena Cupidore RN1, Helen Jackson RN1, Richard J. Hayes BSc, MSc1, and Graham R. Serjeant MD, FRCP1

1 From the Medical Research Council Laboratories, University of the West Indies, Mona, Kingston, Jamaica, and the Tropical Epidemiology Unit, London School of Hygiene and Tropical Medicine, London

In a longitudinal study of 298 children with homozygous sickle cell (SS) disease and 157 children with hemoglobin SC disease, between birth and 9 years of age, observations of weight and height were made. These were compared with similar data derived from an age- and sex-matched group of 231 children with a normal hemoglobin (AA) genotype. Growth in children with SC disease was not significantly different from that in normal children, but children with SS disease had statistically significant, and progressive, deficits in both weight and height before 2 years of age. The average deficit approached 1 SD below the normal mean for age by 9 years. Observations of skeletal maturity, based on radiologic assessment of bone age at the wrist, were made on a proportion of these children at 5 and 8 years of age. Children with SS disease were significantly retarded at 8 years but not 5 years, which is consistent with increasing deficit in height. These observations confirm the early impact of SS disease on physical development and provide standards from which clinical expectations of growth may be derived. The relevance of these findings and their relationship to the characteristic delay in pubertal development is discussed together with a review of possible etiologic factors. The benign nature of SC disease is endorsed by the absence of an effect on growth in the prepubertal child.

Key Words: growth • bone age • sickle cell anemia

Submitted on June 3, 1985
Accepted on August 14, 1985




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