Although uncommon, the achondroplastic dwarf (AD) may become the victim of multiple trauma, presenting special challenges for the emergency department (ED) physician. Traditional management of airway, breathing, circulation, and neurological disability is altered by the unique anatomic features of achondroplasia. Despite facial abnormalities observed in the AD, orotracheal and nasotracheal intubation are usually accomplished without particular difficulty; however, abnormalities of the base of the skull and cervical spine make hyperextension of the neck especially hazardous in these patients. The lungs are functionally normal, although vital capacity is decreased and thoracic case abnormalities and abdominal obesity impair lung expansion. Vascular access in the AD is difficult. Peripheral access is difficult because of excessive subcutaneous fat, whereas central venous access is complicated by neck, chest wall, and spinal abnormalities that obscure commonly used anatomic landmarks. Major neurological syndromes observed in ADs are hydrocephalus, cervical medullary compression, and thoracolumbar stenosis. The ED physician should recognize these syndromes, their potential to produce neurological disability, and their unique implications for trauma. source pubmed.gov
If left untreated, growth hormone deficiency will lead to short stature and delayed puberty.
Growth hormone deficiency may occur with deficiencies of other hormones, including the following:
Thyrotropins (control production of thyroid hormones)
Vasopressin (controls water balance in the body)
Gonadotropins (control production of male and female sex hormones)
Adrenocorticotrophic hormone or ACTH (controls the adrenal gland and its production of cortisol, DHEA, and other hormones)
source:
http://www.nlm.nih.gov/medlineplus/ency/article/001176.htm:
An abnormally short height in childhood (called short stature) may occur if there is not enough growth hormone produced. Growth hormone is produced in the pituitary gland, which is located at the base of the brain.
Most of the time, no cause is found.
Growth hormone deficiency may be present at birth (congenital) or acquired as the result of an injury or medical condition.
Children with physical defects of the face and skull, such as cleft lip or cleft palate, can also have decreased growth hormone levels.
Growth hormone deficiency also can be caused by severe brain injury.
Growth retardation may first be noticed in infancy and continue throughout childhood. The pediatrician will usually plot the child's "growth curve" on a standardized growth chart. The child's growth may range from flat (no growth) to very shallow (minimal growth). Normal puberty may or may not occur, depending on how well the pituitary gland can produce hormones other than growth hormone.
Although it is uncommon, growth hormone deficiency may also be diagnosed in adults. Possible causes include:
Hormonal problems involving the pituitary gland or hypothalamus
Brain radiation treatments for cancer
Severe head injury
source:
http://www.nlm.nih.gov/medlineplus/ency/article/001176.htm
