Saturday, June 26, 2010

After 10 years, boy starts to grow again

When Peter Mwega was 13 he was easily mistaken for a three year old because he looked smaller than children his age.

In his class, he was the smallest boy and fellow pupils teased him and carried him around like a toddler. Even his younger sister looked bigger than him.

"Mwega was normal at birth in 1996, but when he was three, his suddenly stopped growing. I was worried but I didn’t know what to do. I though it was just the work of nature," Mwega’s mother, Anne Waithera, says.

For the next 10 years, Mwega did not grow even an inch.

Healthy children grow a minimum of two and a half inches each year after the age of two and before puberty.

"Neighbours whispered that my third born had been bewitched and others urged me to pray to God to ‘remove’ the affliction. I almost believed the tale especially because my other children were normal," she says.

Though 13 is usually considered an unlucky number, when Mwega turned 13, luck came his way.

Then, he was in Class Five at Nelian Academy in Githurai. A medical student from the University of Nairobi learnt about Mwega’s condition.

He reported the matter to his lecturer Lucy Mungai, one of the four local specialists — known as endocrinologists — in treating growth disorders.

"I first examined Mwega when he was 13 and his bones were of a three-year-old.

He was suffering from a severe shortage of growth hormones to stimulate muscle and bone development," says Dr Mungai.

At Sh50,000, the initial tests for Mwega were too expensive for Waithera, who is a casual worker in Government. But thanks to a fundraiser by friends and relatives, she raised the cash.

The growth hormones Mwega needed cost Sh200,000 per month. Waithera was almost giving up when a Swedish friend of Mungai offered to help.

Big enough

Since November last year when he started treatment, Mwega has grown taller.

"We hope that in several years he will be tall and big enough to escape second glances from people and to look his actual age," says Mungai.

Early this month, Mwega spoke at an international conference of paediatric endocrinologists showcasing his encouraging improvement after hormonal treatment.

"I am looking forward to becoming an engineer and help my parents. I can’t wait to be as tall as my peers," he said, as the room broke into applause.

Mungai also hopes the high prices of growth hormones will come down to make them affordable to the majority.

But the East Africa Manager of Novo Nordisk, a Danish company that supplies the hormones, said the prices are still high because the market is small.

Waithera is happy her son has found treatment for his condition. She is, however, disturbed that many children could be facing the same problem but with no forthcoming help.

Growth problems usually occur when the pituitary gland fails to function as it should. The pituitary gland distributes hormones — including the growth hormone somatotropin — to various parts of the body. Somatotropin stimulates the growth of muscle and bone in growing children.

The growth hormones

Either overproduction or underproduction of this hormone can cause growth abnormalities. The secretion of too little growth hormone by the pituitary causes dwarfism while too much causes the body to grow in an exaggerated fashion, resulting in abnormally large hands, feet and jaw.

Some cases of malfunction of the pituitary are caused by the growth of a tumour on the gland.

In some cases, growth problems are caused by the failure of the thyroid gland to function properly. The thymus gland may also be involved.

Nutrition

If the thymus gland of an infant is damaged development is retarded, and the child has a greater than normal susceptibility to infection. Nutrition can also play a significant role in the growth and development of a child.

When evaluating a child’s growth, it is the overall growth pattern, rather than size, that is important. If a child seems to "fall off" a previously steady growth curve, he or she should be evaluated for possible nutritional deficiencies and other underlying health problems.

If growth is slowed because of insufficient growth hormone production, a health care provider may prescribe growth hormone therapy.

If growth problems are the result of a tumour of the pituitary gland, surgical removal or treatment may be recommended.

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