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SEDE: HOSPITAL DEL NIÑO DIF, HIDALGO
3er Curso «TEMAS SELECTOS EN PEDIATRÍA»
TEMA: TALLA BAJA
DRA. LAURA ROSA CORNEJO ROLDÁN
PACHUCA, HGO DEL 10 AL 12 DE JULIO DE 2013
TALLA BAJA
DEFINICIÓN: ESTATURA QUE SE
ENCUENTRA POR DEBAJO DE
PERCENTILA 3 PARA SU EDAD
TALLA BAJA
• FRECUENCIA:
5% DE MALFORMACIONES
1% DE LAS MUERTES
PERINATALES;
23% DE ÓBITOS
1/5,000 RECIEN NACIDOS VIVOS
TALLA BAJA
PROPORCIONADA
• CONSTITUCIONAL
• FAMILIAR
• ENDOCRINOPATÍAS
Alanay Y. A Review of the Principles of Radiological Assessment of Skeletal Dysplasias. J Clin Res
Pediatr Endocrinol. 2011; 3(4):163-178
TALLA BAJA
• FAMILIAR
• RETRASO CONSTITUCIONAL DEL
CRECIMIENTO
• CROMOSOMOPATÍAS (19%)
• SÍNDROMES MALFORMATIVOS (3%)
• ENFERMEDAD: CARDIACA, PULMONAR,
RENAL, GASTROINTESTINAL O
ENDOCRINAS (2%)
Seaver LH, Irons M. ACMG practice guidelines: Genetic evaluation of short stature. Genet Med. 2009:11(6):465-
470.
TALLA BAJA
CLASIFICACIONES
• PROPORCIONADA O DESPROPORCIONADA
• COMPATIBLE CON LA VIDA O LETAL
• ESPORÁDICA O FAMILIAR
• AISLADA O SINDROMÁTICA
• FORMA DE HERENCIA
TALLA BAJA
PRENATAL
• SALUD MATERNA:
– ENDOCRINOPATÍAS, IMAGEN DE
PITUITARIA
– HIPOGLICEMIA
• TERATÓGENOS
• EMBARAZO: INCLUIDO PLACENTA
• INFECCIONES
Seaver LH, Irons M. ACMG practice guidelines: Genetic evaluation of short stature. Genet Med.
2009:11(6):465-470.
TALLA BAJA
PRENATAL
• DISPLASIA ÓSEA
• EVALUACIONES: OFTALMOLÓGICA Y
AUDITIVA
• CARIOTIPO DE ALTA
RESOLUCIÓN/MICROARREGLOS
Seaver LH, Irons M. ACMG practice guidelines: Genetic evaluation of short stature. Genet Med.
2009:11(6):465-470.
• BIOMETRÍA HEMÁTICA COMPLETA
• FERRITINA
ANEMIA
INFECCIONES
ENFERMEDAD CELIACA
FIBROSIS QUÍSTICA
Grote FK. The diagnostic work up of growth failure in secondary health care; An evaluation of
consensus guidelines. BMC Pediatrics. 2008; 8:21. Disponible en http://www.biomedcentral.com/1471-
2431/8/21.
TALLA BAJA
ESTUDIOS DE LABORATORIO
TALLA BAJA
ESTUDIOS DE LABORATORIO
• PRUEBAS FUNCIONALES
HEPÁTICAS
ENFERMEDADES HEPÁTICAS
Grote FK. The diagnostic work up of growth failure in secondary health care; An evaluation of
consensus guidelines. BMC Pediatrics. 2008; 8:21. Disponible en http://www.biomedcentral.com/1471-
2431/8/21.
TALLA BAJA
ESTUDIOS DE LABORATORIO
• ALBÚMINA
• CREATININA
• SODIO
• POTASIO
• CALCIO ENFERMEDADES RENALES
• FOSFATO
• FOSFATASA ALCALINA
• EQUILIBRIO ÁCIDO-BASE
• EXAMEN GENERAL DE ORINA
Grote FK. The diagnostic work up of growth failure in secondary health care; An evaluation of consensus
guidelines. BMC Pediatrics. 2008; 8:21. Disponible en http://www.biomedcentral.com/1471-2431/8/21.
TALLA BAJA
ESTUDIOS DE LABORATORIO
• PERFIL TIROIDEO
• HORMONA DE CRECIMIENTO
• FSH Y CARIOTIPO
HIPOTIROIDISMO
DEFICIENCIA DE HORMONA DE
CRECIMIENTO
SÍNDROME DE TURNER
Grote FK. The diagnostic work up of growth failure in secondary health care; An evaluation of
consensus guidelines. BMC Pediatrics. 2008; 8:21. Disponible en http://www.biomedcentral.com/1471-
2431/8/21.
TALLA BAJA
ESTUDIOS DE LABORATORIO
• PRUEBAS INMUNOLÓGICAS
• BIOPSIA: DETERMINACIÓN DE ZINC
ENFERMEDAD CELIACA
Grote FK. The diagnostic work up of growth failure in secondary health care; An evaluation of
consensus guidelines. BMC Pediatrics. 2008; 8:21. Disponible en http://www.biomedcentral.com/1471-
2431/8/21.
TALLA BAJA
ESTUDIOS DE LABORATORIO
• ANÁLISIS DE EXCREMENTO
• ESTEROIDES SÉRICOS
• PRUEBAS ALÉRGICAS
Grote FK. The diagnostic work up of growth failure in secondary health care; An evaluation of
consensus guidelines. BMC Pediatrics. 2008; 8:21. Disponible en http://www.biomedcentral.com/1471-
2431/8/21.
TALLA BAJA
ESTUDIOS DE GABINETE
• SERIE ÓSEA
• EDAD ÓSEA
• ULTRASONIDO ABDOMINAL
• ULTRASONIDO RENAL
• RESONANCIA MAGNÉTICA
• TOMOGRAFÍA AXIAL
COMPUTARIZADA
• e FK. The diagnostic work up of growth failure in secondary health care; An evaluation of
consensus guidelines. BMC Pediatrics. 2008; 8:21. Disponible en
http://www.biomedcentral.com/1471-2431/8/21.
TALLA BAJA
ANTROPOMETRÍA
Hall JG, Froster-Iskenius UG, Allanson JE. Handbook of Normal Physical Measurements. Oxford
University Press. Oxford. 1995.
TALLA BAJA
EDAD ÓSEA
Hall JG, Froster-Iskenius UG, Allanson JE. Handbook of Normal Physical Measurements. Oxford
University Press. Oxford. 1995.
TALLA BAJA
SERIE ÓSEA
• AP Y LATERAL DE CRÁNEO
• SENOS PARANASALES
• WATERS
TALLA BAJA
SERIE ÓSEA
• AP Y LATERAL DE TODA LA
COLUMNA
• TÓRAX ÓSEO
• AP DE PELVIS
TALLA BAJA
SERIE ÓSEA
• AP COMPARATIVAS DE
EXTREMIDADES SUPERIORES E
INFERIORES
• AP COMPARATIVAS DE MANOS Y
PIES
TALLA BAJA
DISPLASIAS ÓSEAS
• EXISTEN ALREDEDOR DE 450
• 40 GRUPOS
• 226 GENES
• 316 MUTACIONES
Warman ML, Cormier-Daire V, Hall C, Krakow D, Lachman R, LeMerrer M, et al. Nosology and
classification of genetic skeletal disorers:2010 revision. Am J Med Genet. 2011; 155:943-968.
TALLA BAJA
FORMA DE HERENCIA
ÁRBOL GENEALÓGICO
• AUTOSÓMICO DOMINANTE
• AUTOSÓMICO RECESIVA
• LIGADA AL X RECESIVA
TALLA BAJA
FORMA DE HERENCIA
CONSIDERACIONES ESPECIALES
• ESPORÁDICO
• MUTACIÓN DE NOVO
• EPIGENÉTICA
TALLA BAJA
ASESORAMIENTO GENÉTICO
• RIESGO DE OCURRENCIA
• RIESGO DE RECURRENCIA
• ESTUDIO MOLECULAR
ACONDROPLASIA
GEN SHOX
TALLA BAJA
ALGORTIMO
Seaver LH, Irons M. ACMG practice guidelines: Genetic evaluation of short stature. Genet Med.
2009:11(6):465-470.
TALLA BAJA
LIGAS DE INTERNET PARA FOTOS
http://www.ncbi.nlm.nih.gov/pmc/articles/instance/2525684/bin/pbio.0060208.g006.gif
http://www.ncbi.nlm.nih.gov/pmc/articles/instance/1180335/bin/AJHGv72p1040fg1.jpg
http://t0.gstatic.com/images?q=tbn:ANd9GcRQdrJNcwPjwYTUwS2piCRdnzbYdyiljirf0AwKmDGpH33FyTKe
http://www.ncbi.nlm.nih.gov/pmc/articles/instance/1271388/bin/AJHGv77p795fg1.gif
http://t1.gstatic.com/images?q=tbn:ANd9GcQ18JunIyjfm9DNZy_EW2iX168jANGWaLJwWFA2VFfjyWBGdr7apw
http://t3.gstatic.com/images?q=tbn:ANd9GcQIdiPimZWZPnrJ1oEloofPMrq9MEtMDWHQ-TrUyBaT8ix7v0O_
Courtesy: Dr Robert CARLIER, CHU Raymond Poincaré, Garches, France. En: Germain DP. Orphanet Journal of Rare
Diseases 2010, 5:30. Disponible en: http://www.ojrd.com/content/5/1/30
Cortesía para BIOMARIN Pharmaceutical por The National MPS Society Inc.
http://www.ncbi.nlm.nih.gov/pmc/articles/instance/3537291/bin/JCRPE-4-220-g1.jpg
http://www.ncbi.nlm.nih.gov/pmc/articles/instance/3475919/bin/IJEM-16-840-g001.gif
http://www.ncbi.nlm.nih.gov/pmc/articles/instance/3475919/bin/IJEM-16-840-g001.gif
http://www.ncbi.nlm.nih.gov/pmc/articles/instance/1287918/bin/AJHGv67p1411fg1.gif
http://t2.gstatic.com/images?q=tbn:ANd9GcQ8A3qEuJoNCm8P_BSMGN2DVImQNfx4nISl2TEwNHiMnMCINo-J
http://t2.gstatic.com/images?q=tbn:ANd9GcSFIKR3waQPOgQJfCBRMKucArUipPNgXM_nMvlwOa_gt0pH7rK-Kg
¡GRACIAS!

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POST NATAL EXERCISES AND ITS IMPACT.pptx
 

Puntos que debes considerar al estudiar Talla Baja en Genética

  • 1. SEDE: HOSPITAL DEL NIÑO DIF, HIDALGO 3er Curso «TEMAS SELECTOS EN PEDIATRÍA» TEMA: TALLA BAJA DRA. LAURA ROSA CORNEJO ROLDÁN PACHUCA, HGO DEL 10 AL 12 DE JULIO DE 2013
  • 2. TALLA BAJA DEFINICIÓN: ESTATURA QUE SE ENCUENTRA POR DEBAJO DE PERCENTILA 3 PARA SU EDAD
  • 3. TALLA BAJA • FRECUENCIA: 5% DE MALFORMACIONES 1% DE LAS MUERTES PERINATALES; 23% DE ÓBITOS 1/5,000 RECIEN NACIDOS VIVOS
  • 4. TALLA BAJA PROPORCIONADA • CONSTITUCIONAL • FAMILIAR • ENDOCRINOPATÍAS Alanay Y. A Review of the Principles of Radiological Assessment of Skeletal Dysplasias. J Clin Res Pediatr Endocrinol. 2011; 3(4):163-178
  • 5. TALLA BAJA • FAMILIAR • RETRASO CONSTITUCIONAL DEL CRECIMIENTO • CROMOSOMOPATÍAS (19%) • SÍNDROMES MALFORMATIVOS (3%) • ENFERMEDAD: CARDIACA, PULMONAR, RENAL, GASTROINTESTINAL O ENDOCRINAS (2%) Seaver LH, Irons M. ACMG practice guidelines: Genetic evaluation of short stature. Genet Med. 2009:11(6):465- 470.
  • 6. TALLA BAJA CLASIFICACIONES • PROPORCIONADA O DESPROPORCIONADA • COMPATIBLE CON LA VIDA O LETAL • ESPORÁDICA O FAMILIAR • AISLADA O SINDROMÁTICA • FORMA DE HERENCIA
  • 7. TALLA BAJA PRENATAL • SALUD MATERNA: – ENDOCRINOPATÍAS, IMAGEN DE PITUITARIA – HIPOGLICEMIA • TERATÓGENOS • EMBARAZO: INCLUIDO PLACENTA • INFECCIONES Seaver LH, Irons M. ACMG practice guidelines: Genetic evaluation of short stature. Genet Med. 2009:11(6):465-470.
  • 8. TALLA BAJA PRENATAL • DISPLASIA ÓSEA • EVALUACIONES: OFTALMOLÓGICA Y AUDITIVA • CARIOTIPO DE ALTA RESOLUCIÓN/MICROARREGLOS Seaver LH, Irons M. ACMG practice guidelines: Genetic evaluation of short stature. Genet Med. 2009:11(6):465-470.
  • 9. • BIOMETRÍA HEMÁTICA COMPLETA • FERRITINA ANEMIA INFECCIONES ENFERMEDAD CELIACA FIBROSIS QUÍSTICA Grote FK. The diagnostic work up of growth failure in secondary health care; An evaluation of consensus guidelines. BMC Pediatrics. 2008; 8:21. Disponible en http://www.biomedcentral.com/1471- 2431/8/21. TALLA BAJA ESTUDIOS DE LABORATORIO
  • 10. TALLA BAJA ESTUDIOS DE LABORATORIO • PRUEBAS FUNCIONALES HEPÁTICAS ENFERMEDADES HEPÁTICAS Grote FK. The diagnostic work up of growth failure in secondary health care; An evaluation of consensus guidelines. BMC Pediatrics. 2008; 8:21. Disponible en http://www.biomedcentral.com/1471- 2431/8/21.
  • 11. TALLA BAJA ESTUDIOS DE LABORATORIO • ALBÚMINA • CREATININA • SODIO • POTASIO • CALCIO ENFERMEDADES RENALES • FOSFATO • FOSFATASA ALCALINA • EQUILIBRIO ÁCIDO-BASE • EXAMEN GENERAL DE ORINA Grote FK. The diagnostic work up of growth failure in secondary health care; An evaluation of consensus guidelines. BMC Pediatrics. 2008; 8:21. Disponible en http://www.biomedcentral.com/1471-2431/8/21.
  • 12. TALLA BAJA ESTUDIOS DE LABORATORIO • PERFIL TIROIDEO • HORMONA DE CRECIMIENTO • FSH Y CARIOTIPO HIPOTIROIDISMO DEFICIENCIA DE HORMONA DE CRECIMIENTO SÍNDROME DE TURNER Grote FK. The diagnostic work up of growth failure in secondary health care; An evaluation of consensus guidelines. BMC Pediatrics. 2008; 8:21. Disponible en http://www.biomedcentral.com/1471- 2431/8/21.
  • 13. TALLA BAJA ESTUDIOS DE LABORATORIO • PRUEBAS INMUNOLÓGICAS • BIOPSIA: DETERMINACIÓN DE ZINC ENFERMEDAD CELIACA Grote FK. The diagnostic work up of growth failure in secondary health care; An evaluation of consensus guidelines. BMC Pediatrics. 2008; 8:21. Disponible en http://www.biomedcentral.com/1471- 2431/8/21.
  • 14. TALLA BAJA ESTUDIOS DE LABORATORIO • ANÁLISIS DE EXCREMENTO • ESTEROIDES SÉRICOS • PRUEBAS ALÉRGICAS Grote FK. The diagnostic work up of growth failure in secondary health care; An evaluation of consensus guidelines. BMC Pediatrics. 2008; 8:21. Disponible en http://www.biomedcentral.com/1471- 2431/8/21.
  • 15. TALLA BAJA ESTUDIOS DE GABINETE • SERIE ÓSEA • EDAD ÓSEA • ULTRASONIDO ABDOMINAL • ULTRASONIDO RENAL • RESONANCIA MAGNÉTICA • TOMOGRAFÍA AXIAL COMPUTARIZADA • e FK. The diagnostic work up of growth failure in secondary health care; An evaluation of consensus guidelines. BMC Pediatrics. 2008; 8:21. Disponible en http://www.biomedcentral.com/1471-2431/8/21.
  • 16. TALLA BAJA ANTROPOMETRÍA Hall JG, Froster-Iskenius UG, Allanson JE. Handbook of Normal Physical Measurements. Oxford University Press. Oxford. 1995.
  • 17. TALLA BAJA EDAD ÓSEA Hall JG, Froster-Iskenius UG, Allanson JE. Handbook of Normal Physical Measurements. Oxford University Press. Oxford. 1995.
  • 18. TALLA BAJA SERIE ÓSEA • AP Y LATERAL DE CRÁNEO • SENOS PARANASALES • WATERS
  • 19. TALLA BAJA SERIE ÓSEA • AP Y LATERAL DE TODA LA COLUMNA • TÓRAX ÓSEO • AP DE PELVIS
  • 20. TALLA BAJA SERIE ÓSEA • AP COMPARATIVAS DE EXTREMIDADES SUPERIORES E INFERIORES • AP COMPARATIVAS DE MANOS Y PIES
  • 21. TALLA BAJA DISPLASIAS ÓSEAS • EXISTEN ALREDEDOR DE 450 • 40 GRUPOS • 226 GENES • 316 MUTACIONES Warman ML, Cormier-Daire V, Hall C, Krakow D, Lachman R, LeMerrer M, et al. Nosology and classification of genetic skeletal disorers:2010 revision. Am J Med Genet. 2011; 155:943-968.
  • 22. TALLA BAJA FORMA DE HERENCIA ÁRBOL GENEALÓGICO • AUTOSÓMICO DOMINANTE • AUTOSÓMICO RECESIVA • LIGADA AL X RECESIVA
  • 23. TALLA BAJA FORMA DE HERENCIA CONSIDERACIONES ESPECIALES • ESPORÁDICO • MUTACIÓN DE NOVO • EPIGENÉTICA
  • 24. TALLA BAJA ASESORAMIENTO GENÉTICO • RIESGO DE OCURRENCIA • RIESGO DE RECURRENCIA • ESTUDIO MOLECULAR
  • 27. TALLA BAJA ALGORTIMO Seaver LH, Irons M. ACMG practice guidelines: Genetic evaluation of short stature. Genet Med. 2009:11(6):465-470.
  • 28. TALLA BAJA LIGAS DE INTERNET PARA FOTOS http://www.ncbi.nlm.nih.gov/pmc/articles/instance/2525684/bin/pbio.0060208.g006.gif http://www.ncbi.nlm.nih.gov/pmc/articles/instance/1180335/bin/AJHGv72p1040fg1.jpg http://t0.gstatic.com/images?q=tbn:ANd9GcRQdrJNcwPjwYTUwS2piCRdnzbYdyiljirf0AwKmDGpH33FyTKe http://www.ncbi.nlm.nih.gov/pmc/articles/instance/1271388/bin/AJHGv77p795fg1.gif http://t1.gstatic.com/images?q=tbn:ANd9GcQ18JunIyjfm9DNZy_EW2iX168jANGWaLJwWFA2VFfjyWBGdr7apw http://t3.gstatic.com/images?q=tbn:ANd9GcQIdiPimZWZPnrJ1oEloofPMrq9MEtMDWHQ-TrUyBaT8ix7v0O_ Courtesy: Dr Robert CARLIER, CHU Raymond Poincaré, Garches, France. En: Germain DP. Orphanet Journal of Rare Diseases 2010, 5:30. Disponible en: http://www.ojrd.com/content/5/1/30 Cortesía para BIOMARIN Pharmaceutical por The National MPS Society Inc. http://www.ncbi.nlm.nih.gov/pmc/articles/instance/3537291/bin/JCRPE-4-220-g1.jpg http://www.ncbi.nlm.nih.gov/pmc/articles/instance/3475919/bin/IJEM-16-840-g001.gif http://www.ncbi.nlm.nih.gov/pmc/articles/instance/3475919/bin/IJEM-16-840-g001.gif http://www.ncbi.nlm.nih.gov/pmc/articles/instance/1287918/bin/AJHGv67p1411fg1.gif http://t2.gstatic.com/images?q=tbn:ANd9GcQ8A3qEuJoNCm8P_BSMGN2DVImQNfx4nISl2TEwNHiMnMCINo-J http://t2.gstatic.com/images?q=tbn:ANd9GcSFIKR3waQPOgQJfCBRMKucArUipPNgXM_nMvlwOa_gt0pH7rK-Kg