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The Pattern of Growth Failure in Rett Syndrome

The Pattern of Growth Failure in Rett Syndrome Abstract • Objective. —To define the growth pattern of girls with Rett syndrome with respect to height, weight, and fronto-occipital head circumference. Design. —Longitudinal with irregular intervals between measurements. Setting. —Rett Syndrome Program Project at Baylor College of Medicine, Houston, Tex. Participants. —Ninety-six girls fulfilling criteria for Rett syndrome; comparison group with standard growth curves. Selection Procedure. —Consecutive entries into the Rett Syndrome Program Project. Intervention. —None. Measurements/Main Results. —Height, weight, and fronto-occipital head circumference data were grouped into intervals. Group medians were then generated. Regression lines were fitted through the median points and plotted on standard growth charts. Deceleration of growth velocities began at age 3 months and persisted through age 18 years. Conclusions. —Early deceleration of head growth, followed by deceleration of weight and height measurements, appears to be a growth pattern characteristic of Rett syndrome. This pattern of growth may provide the earliest clinical indicator for the diagnosis of Rett syndrome.(AJDC. 1993;147:633-637) References 1. The Rett Syndrome Diagnostic Criteria Work Group. Diagnostic criteria for Rett syndrome . Ann Neurol . 1988;23:425-428.Crossref 2. Hagberg B, Aicardi J, Dias K, Ramos O. A progressive syndrome of autism, dementia, ataxia, and loss of purposeful hand use in girls: Rett syndrome: report of 35 cases . Ann Neurol . 1983;14:471-479.Crossref 3. Percy AK, Zoghbi H, Riccardi VM. Rett syndrome: initial experience with an emerging clinical entity . Brain Dev . 1985;7:300-304.Crossref 4. Holm VA. Physical growth and development in patients with Rett syndrome . Am J Med Genet . 1986;24:119-126.Crossref 5. Budden SS. Rett syndrome: studies of 13 affected girls . Am J Med Genet . 1986;24:99-109.Crossref 6. Rice MA, Haas RH. The nutritional aspects of Rett syndrome . J Child Neurol . 1988;3( (suppl) ):S35-S42.Crossref 7. Percy AK, Armstrong DD. Rett syndrome: a pervasive disorder of growth . Pediatr Res . 1988;23:556A. 8. Ashton-Tate Corp. dBASE III Plus, Version 1.1 . Torrance, Calif: Ashton-Tate Corp; 1985. 9. Computing Resource Center. STATA, Version 2.05, Release 2 . Los Angeles, Calif: Computing Resource Center; 1989. 10. Nellhaus G. Head circumference from birth to eighteen years: practical composite international and interracial graphs . Pediatrics . 1968;41: 106-114. 11. Hamill PVV, Drizd TA, Johnson CL, Reed RB, Roche AF, Moore WM. Physical growth: National Center for Health Statistics percentiles . Am J Clin Nutr . 1979;32:607-629. 12. Staehling N, Sullivan K. Foranth. Atlanta, Ga: Nutrition Division, Centers for Disease Control and Prevention; 1990. 13. Thommessen M, Heiberg A, Kase BF, Larsen S, Riis G. Feeding problems, height and weight in different groups of disabled children . Acta Paediatr Scand . 1991;80:527-533.Crossref 14. Tobis JS, Saturen P, Larios G, Posniak AO. Study of growth patterns in cerebral palsy . Arch Phys Med Rehabil . 1961;6:475-481. 15. Shapiro BK, Green P, Krick J, Allen D, Capute AJ. Growth of severely impaired children: neurological versus nutritional factors . Dev Med Child Neurol . 1986;28:729-733.Crossref 16. Pryor HB, Thelander JE. Growth deviations in handicapped children . Clin Pediatr . 1967;6:501-512.Crossref 17. Pueschel SM. Growth, thyroid function, and sexual maturation in Down syndrome . Growth Genet Horm . 1990;6:1-5. 18. Underwood LE, Van Wyk JJ. Normal and aberrant growth . In: Wilson JD, Foster DW, eds. Williams Textbook of Endocrinology . Philadelphia, Pa: WB Saunders Co; 1985:155-205. 19. Cronk C, Crocker AC, Pueschel SM, et al. Growth charts for children with Down syndrome: 1 month to 18 years of age . Pediatrics . 1988;81:102-110. 20. Mosier HD, Grossman HJ, Dingman HF. Physical growth in mental defectives . Pediatrics . 1965;36:465-519. 21. Palmer CGS, Cronk C, Pueschel SM, et al. Head circumference of children with Down syndrome (0-36 months) . Am J Med Genet . 1992;42: 61-67.Crossref 22. Olsson B, Rett A. Behavioral observations concerning differential diagnosis between the Rett syndrome and autism . Brain Dev . 1985;7:281-289.Crossref 23. Ruby DO, Matheny WD. Comments on growth of cerebral palsied children . J Am Diet Assoc . 1962;40:525-527. 24. Waterlow JC. Classification and definition of protein-calorie malnutrition . BMJ . 1972;3:566-569.Crossref 25. Waterlow JC. Note on the assessment and classification of protein-energy malnutrition in children . Lancet . 1973;2:87-89.Crossref 26. Jellinger K, Armstrong D, Zoghbi HY, Percy AK. Neuropathology of Rett syndrome . Acta Neuropathol . 1988;76:142-158.Crossref 27. Hagberg B. Rett syndrome: clinical peculiarities, diagnostic approach, and possible cause . Pediatr Neurol . 1989;5:75-83.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Diseases of Children American Medical Association

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Publisher
American Medical Association
Copyright
Copyright © 1993 American Medical Association. All Rights Reserved.
ISSN
0002-922X
DOI
10.1001/archpedi.1993.02160300039018
Publisher site
See Article on Publisher Site

Abstract

Abstract • Objective. —To define the growth pattern of girls with Rett syndrome with respect to height, weight, and fronto-occipital head circumference. Design. —Longitudinal with irregular intervals between measurements. Setting. —Rett Syndrome Program Project at Baylor College of Medicine, Houston, Tex. Participants. —Ninety-six girls fulfilling criteria for Rett syndrome; comparison group with standard growth curves. Selection Procedure. —Consecutive entries into the Rett Syndrome Program Project. Intervention. —None. Measurements/Main Results. —Height, weight, and fronto-occipital head circumference data were grouped into intervals. Group medians were then generated. Regression lines were fitted through the median points and plotted on standard growth charts. Deceleration of growth velocities began at age 3 months and persisted through age 18 years. Conclusions. —Early deceleration of head growth, followed by deceleration of weight and height measurements, appears to be a growth pattern characteristic of Rett syndrome. This pattern of growth may provide the earliest clinical indicator for the diagnosis of Rett syndrome.(AJDC. 1993;147:633-637) References 1. The Rett Syndrome Diagnostic Criteria Work Group. Diagnostic criteria for Rett syndrome . Ann Neurol . 1988;23:425-428.Crossref 2. Hagberg B, Aicardi J, Dias K, Ramos O. A progressive syndrome of autism, dementia, ataxia, and loss of purposeful hand use in girls: Rett syndrome: report of 35 cases . Ann Neurol . 1983;14:471-479.Crossref 3. Percy AK, Zoghbi H, Riccardi VM. Rett syndrome: initial experience with an emerging clinical entity . Brain Dev . 1985;7:300-304.Crossref 4. Holm VA. Physical growth and development in patients with Rett syndrome . Am J Med Genet . 1986;24:119-126.Crossref 5. Budden SS. Rett syndrome: studies of 13 affected girls . Am J Med Genet . 1986;24:99-109.Crossref 6. Rice MA, Haas RH. The nutritional aspects of Rett syndrome . J Child Neurol . 1988;3( (suppl) ):S35-S42.Crossref 7. Percy AK, Armstrong DD. Rett syndrome: a pervasive disorder of growth . Pediatr Res . 1988;23:556A. 8. Ashton-Tate Corp. dBASE III Plus, Version 1.1 . Torrance, Calif: Ashton-Tate Corp; 1985. 9. Computing Resource Center. STATA, Version 2.05, Release 2 . Los Angeles, Calif: Computing Resource Center; 1989. 10. Nellhaus G. Head circumference from birth to eighteen years: practical composite international and interracial graphs . Pediatrics . 1968;41: 106-114. 11. Hamill PVV, Drizd TA, Johnson CL, Reed RB, Roche AF, Moore WM. Physical growth: National Center for Health Statistics percentiles . Am J Clin Nutr . 1979;32:607-629. 12. Staehling N, Sullivan K. Foranth. Atlanta, Ga: Nutrition Division, Centers for Disease Control and Prevention; 1990. 13. Thommessen M, Heiberg A, Kase BF, Larsen S, Riis G. Feeding problems, height and weight in different groups of disabled children . Acta Paediatr Scand . 1991;80:527-533.Crossref 14. Tobis JS, Saturen P, Larios G, Posniak AO. Study of growth patterns in cerebral palsy . Arch Phys Med Rehabil . 1961;6:475-481. 15. Shapiro BK, Green P, Krick J, Allen D, Capute AJ. Growth of severely impaired children: neurological versus nutritional factors . Dev Med Child Neurol . 1986;28:729-733.Crossref 16. Pryor HB, Thelander JE. Growth deviations in handicapped children . Clin Pediatr . 1967;6:501-512.Crossref 17. Pueschel SM. Growth, thyroid function, and sexual maturation in Down syndrome . Growth Genet Horm . 1990;6:1-5. 18. Underwood LE, Van Wyk JJ. Normal and aberrant growth . In: Wilson JD, Foster DW, eds. Williams Textbook of Endocrinology . Philadelphia, Pa: WB Saunders Co; 1985:155-205. 19. Cronk C, Crocker AC, Pueschel SM, et al. Growth charts for children with Down syndrome: 1 month to 18 years of age . Pediatrics . 1988;81:102-110. 20. Mosier HD, Grossman HJ, Dingman HF. Physical growth in mental defectives . Pediatrics . 1965;36:465-519. 21. Palmer CGS, Cronk C, Pueschel SM, et al. Head circumference of children with Down syndrome (0-36 months) . Am J Med Genet . 1992;42: 61-67.Crossref 22. Olsson B, Rett A. Behavioral observations concerning differential diagnosis between the Rett syndrome and autism . Brain Dev . 1985;7:281-289.Crossref 23. Ruby DO, Matheny WD. Comments on growth of cerebral palsied children . J Am Diet Assoc . 1962;40:525-527. 24. Waterlow JC. Classification and definition of protein-calorie malnutrition . BMJ . 1972;3:566-569.Crossref 25. Waterlow JC. Note on the assessment and classification of protein-energy malnutrition in children . Lancet . 1973;2:87-89.Crossref 26. Jellinger K, Armstrong D, Zoghbi HY, Percy AK. Neuropathology of Rett syndrome . Acta Neuropathol . 1988;76:142-158.Crossref 27. Hagberg B. Rett syndrome: clinical peculiarities, diagnostic approach, and possible cause . Pediatr Neurol . 1989;5:75-83.Crossref

Journal

American Journal of Diseases of ChildrenAmerican Medical Association

Published: Jun 1, 1993

References