Growth velocity measurement in the Marfan syndrome Public Deposited

http://ir.library.oregonstate.edu/concern/graduate_thesis_or_dissertations/j3860966c

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  • Early diagnosis is essential for proper management of the Marfan syndrome, yet due to diverse manifestations of the disorder, specific diagnosis is difficult. Excessive growth of the long bones constitutes a major characteristic of the syndrome; thus differences in growth patterns from those of the average child suggest a possible method of early detection. It was the purpose of this study to demonstrate if velocity of height growth in the Marfan differed during early childhood from that of the normal child. To identify subjects for the study it was first necessary to develop a classification system of Marfan characteristics to insure that only those individuals with a positive Marfan diagnosis were included in the study. From a total of 1017 individuals considered, the final sample was limited to those with a positive Marfan diagnosis for whom measurements were available for at least four of the first five years of life. The sample consisted of seven subjects, four male and three female. It is recognized that because of the limited sample no statistical significance can be attached to the results of the study. For this reason the Case Study method was used for presentation of the results of the study. Findings from this study suggest the possibility that major differences do exist between the patterns of growth velocity demonstrated by Marfan children and those of average children, and also between growth velocity patterns of Marfan boys and Marfan girls. Results of the study also suggest that these differences can be detected during the first months of life. The data from this study indicate that Marfan cases attain a length considerably above average during the first months of life. Regardless of birth lengths, which may or may not be above average, all of the subjects in the study had surpassed average length by age nine months, even the one individual whose birth length was below the fifth percentile. After birth, all of the length and height recordings for all of the Marfan subjects were above average until approximately ten years of age, the entire period of the study. Velocity of height growth was also primarily above average for the Marfan girls throughout the study, while that for the Marfan boys appeared to be slightly below average until age three, after which the height growth velocity for the boys, too, was primarily above average. More contrast became evident in weight recordings and the patterns of weight growth velocity. Between the ages of three months and three years nearly all the weights recorded for the Marfan boys were below average, while nearly all of those recorded for the Marfan girls were above average. After age three, weights recorded for the Marfan boys were predominantly above average, while those for the Marfan girls varied above and below average. From birth until nine months, weight growth velocities for the Marfan boys were all below average while those for the Marfan girls were above average. After that, the velocities of weight growth for both Marfan boys and Marfan girls varied above and below average, the pattern tending to be above. Since Marfans appear to progress beyond average length during the first months of life, the importance of early screening of all infants to detect unusual growth patterns needs to be emphasized to all who work with children during early life. Findings of this study can only suggest implications of the relationship between height growth velocity patterns early in life and possible effects later in life. Further research is indicated to explore in depth the relationship between growth velocity patterns, height, and longevity.
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