According to abbreviationfinder, tall stature (macrosomia) can be a familial variant, but it can also be a serious illness. Tumors or various hereditary factors are the cause. Medical help is recommended in any case of tall stature.
What is tallness?
Physicians define tall stature as a body length that is above the 97th percentile. This means that a person is one of the 3% tallest of his or her peers of the same age group.
A common classification divides the phenomenon of tall stature into two groups: macrosomia (tall stature), which is defined as a body length of over 1.92 m in men and over 1.80 m in women.
One speaks of gigantism (gigantism) when men are over 2.00 m and women over 1.85 m tall. In this definition, the underlying causes are initially not considered. Doctors speak of primordial tall stature when there is a genetically determined and not pathological, above-average height that does not result in any complications.
If the causes are based on disease events, growth disorders occur, which result in disabilities. Hereditary diseases and hormonal disorders are the cause of tall stature in the context of gigantism.
Causes
Tall growth in the pathological form often results from a hormonal imbalance. In most cases, disorders in the pituitary gland (pituitary gland) during the growth phase are responsible.
It is benign tumors that disrupt the production of growth hormones in the central endocrine gland. Tumors can occur in the pancreas ( pancreas ), the tissue of which produces a growth hormone. This shifts the endocrine (hormonal) balance.
An overactive thyroid gland (hyperthyroidism) in the newborn also carries the risk of hormone-related tall stature. Finally, one of the hormonal factors is diabetes that occurs in the mother during pregnancy (gestational diabetes).
Furthermore, chromosomal gene defects such as Marfan and Sotos syndrome have been described as triggers for tall stature. In Klinefelter syndrome, there is an extra X chromosome (sex chromosome) in men (chromosome aberration) and causes pathological tall stature.
Symptoms, Ailments & Signs
Tall stature can be clearly diagnosed based on the characteristic symptoms. The disease can be recognized primarily by the above-average body size of those affected. Affected children usually feel severe growing pains.
Especially during puberty, intense pain occurs in the bones, joints and muscles. Tall growth can also trigger extreme growth spurts and thus cause joint and bone diseases. As the disease progresses, other symptoms can occur, such as inflammation, circulatory disorders or poor posture. In the long term, tall patients develop health problems such as back pain, poor posture and, in individual cases, nerve damage.
Depending on the cause of tall stature, neurological symptoms can also occur. If a tumor is the cause, the corresponding symptoms appear, i.e. neurological disorders, visual disturbances, pain attacks and an increasing feeling of illness. If tall stature is based on a hormonal disorder, severe malaise also occurs, often accompanied by problems with the immune system and the psyche.
An overactive thyroid can cause gastrointestinal problems, skin changes and a variety of other accompanying symptoms. The main symptom of tall stature, which is excessive height, cannot be reversed by treatment. Any side effects usually disappear completely after the growth spurt.
Diagnosis & History
High growth should be examined by a doctor in the event of noticeable growth spurts. He can determine whether it is an illness or whether it is based on a simple normogenetic predisposition. The blood laboratory values provide information about the hormone status, which requires an X-ray diagnosis in the event of deviations. If necessary, magnetic resonance imaging can also be used.
The course of a pathological tall stature varies greatly depending on the form and treatment options. Hormone-induced gigantism leads to imbalanced bone growth. This results in some serious orthopedic clinical pictures. This can be pronounced as partial gigantism and affect only body part regions. In the case of premature sexual maturity (Pubertas praecox), secondary sexual characteristics develop at the age of less than 10 years during tall growth.
Complications
The tall stature does not always have to lead to complications or complaints. In some cases, this is genetic and therefore does not need to be treated by a doctor. In children, tall growth leads to growth disorders, which can be accompanied by pain. It is not uncommon for children to be bullied or teased because of their tall stature, which can lead to psychological problems.
Likewise, tall stature can lead to uneven growth of the bones, resulting in deformities or restricted mobility. Furthermore, there is usually an early development of the sex organs. The treatment of this disease always depends on the cause and is causal. Usually there are no further complications.
If there is a tumour, it can be removed, most often using radiation therapy. Therapy with hormones is also possible to counteract and stop tall growth. It is not uncommon for those affected to also need therapy from an orthopedist and also from a psychologist. Consequential damage in adulthood can thus be avoided. Life expectancy is not reduced by tall stature.
When should you go to the doctor?
If the child complains of severe pain during growth, it is advisable to consult a doctor. Often the tall stature is based on natural causes, but occasionally a disease is the cause that needs to be clarified and treated. Parents who notice such signs in their child should therefore consult a doctor. This is especially true if there is a suspicion of a serious underlying disease. Unusual pressure pain or changes in personality should be clarified quickly.
There may be a tumor or a hormonal disorder that requires therapeutic treatment. Babies diagnosed with an overactive thyroid are particularly prone to hormone-induced tallness. Parents of affected children should consult their pediatrician regularly and arrange for an examination if any unusual symptoms occur. If there are cases of chromosomal genetic defects in the family, the child should be examined promptly after birth. In the case of inheritance, further treatment steps must be initiated to counteract the tall stature and other side effects of the respective syndrome.
Treatment & Therapy
Treating tallness requires intervention during the growth phase. If there is an underlying tumor, surgical intervention may be possible in some cases. However, such operations on the pituitary gland are very risky.
Since these are usually not malignant (malignant) tumors, an operation is often not absolutely necessary. Alternatively, there is the possibility of radiation or chemotherapy. In order to avert a growth disorder, the doctor can order hormone therapy. Estrogens and progestins are female hormones that are used in girls, respectively. In boys, on the other hand, the male hormone testosterone brings about a premature end to growth.
If the doctor diagnoses gestational diabetes in the mother-to- be, the temporary diabetes must be optimally adjusted. In this way, the doctor can counteract excessive growth of the fetus. If medical intervention occurs too late in the course of adolescence, the only option is later treatment of the symptoms in the adult. The orthopedic surgeon is in demand especially in the case of gigantism in order to treat the consequences of the unbalanced bone growth.
The genetically caused variants of tall stature often require speech therapy because speech development is delayed. In Marfan syndrome, any additional heart and vascular diseases must be treated. A wide spectrum of symptoms is generally characteristic of tall stature.
Outlook & Forecast
The prognosis of tall stature depends on the underlying cause and the timing of treatment. If the patient is already fully grown, it is no longer possible to reduce his height. Those affected have a tall stature for the rest of their lives and can receive psychotherapeutic care to help them deal better with their physical size. Due to the natural process, the body only begins to decrease in height by a few centimeters in old age.
In most cases, tall stature is triggered by a genetic disposition or hormonal imbalance. Since an intervention in human genetics is not permitted under the current legal situation, the genetic material cannot be modified. In the case of a familial tall stature, however, a genetic test can be carried out at an early stagebe carried out on the offspring and, if desired, treatment can be initiated during the growth and development process. If there is a disruption in the hormone system, the prognosis is usually optimistic. By administering appropriate hormonal preparations during the growth phase of the body, growth can be slowed down. In many patients, tall stature is less of a problem because of the physical abnormalities. Rather, there are emotional or mental problems due to the visual flaw. It is therefore necessary to check in each individual case whether psychotherapeutic treatment is sufficient to avoid mentally classifying tall stature as a disease.
Prevention
Preventing tall growth is difficult. Only in the case of gestational diabetes can a preventive success be achieved by controlling the blood sugar of the expectant mother. In adolescents, early detection of the syndrome is crucial for any successful therapy for tall stature.
Aftercare
In the case of tall stature, in most cases the affected person has either very few or no aftercare measures available. The disease cannot be treated either, since it is usually a genetic disease. However, the sooner a doctor is contacted, the better the further course of the disease, since further complications or symptoms can be prevented.
The parents of the affected child should therefore consult a doctor at the first signs and symptoms of the disease. If the person concerned wishes to have children, genetic counseling or an examination can also be carried out in order to prevent the disease from recurring. In many cases, those affected suffer from mental disorders or depression.
In order to alleviate this, intensive discussions with parents or friends are usually necessary. However, if the tall growth is caused by a tumor, it must be surgically removed. The further course of the disease depends heavily on the time of diagnosis, so that no general prediction can be made. The patient’s life expectancy may also be reduced as a result of tall stature.
You can do that yourself
If the growth is not yet complete, modern medicine offers the possibility of treating artificially gradually induced synostosis of the epiphyseal plates of the long bones, which leads to slower subsequent growth. In girls, this is done through therapy with estrogens and, if necessary, also with progestins. In boys, therapy starts with testosterone.
Physiotherapy can be used to strengthen the back muscles, which are often vulnerable in people who are very tall. If the cause of tall stature is a genetic disorder, language development and motor skills are often impaired. These symptoms can be addressed by the speech therapist or occupational therapy. Those affected by tall stature can help themselves within the framework of self-help groups. There they can exchange ideas with “companions in suffering”, encourage them and look for common solutions to everyday problems.
For a fulfilling life and an increase in self-esteem, there are also activities in which size is not seen as a problem but as an advantage, as is the case with volleyball or basketball. The increase in self-esteem in those affected by tall stature is also possible through active self-help, which is also important because those affected have been exposed to multiple experiences of bullying and stigmatization.
