Síndrome de Morquio como causa infrecuente de Talla Baja Desproporcionada. Enfoque Fisiopatológico, Diagnóstico y Terapéutico. A Propósito de un Caso

Objective: To describe a case of Morquio syndrome as a rare cause of disproportionate short stature. Case report: Female 11 years old who initiates current disease at 4 years of age with growth retardation, short stature, deformity of the chest and extremities. Three times was hospitalized for respiratory infections She also has persistent nasal obstruction, recurrent tonsillitis, night snoring and hearing loss in the right ear. Physical examination: Weight: 19.8 kg (P <3) Height: 97cm (P <3), BMI: 21.5 (P 90), relation proximal/distal segment: 0.87, growth rate of 0 cm/year. Normocephalic, eyes with hypertelorism and bilateral epicanto, broad nasal bridge keeled chest, scoliosis, and rosary costal. Limbs: epiphyseal thickening, 5th bilateral short metacarpal. Calyx deformity in hands and feet, genus valgus and bilateral flatfoot. Paraclinical: Alkaline phosphatase: 768 mg/dL, calcium: 10 mg/dL, phosphorus 4.1 mg/dL, TSH 2.2 mU/mL, FT4 1.1 ng/dL, PTH: 31.8 ng/dL, remaining unchanged. Bone age of 10 years. Genetic evaluation: Morquio Syndrome. Conclusion: Morquio syndrome is an uncommon cause of disharmonic short stature, and it is a challenge in the diagnosis and treatment. The growth hormone therapy is not recommended routinely because of the few studies on safety and efficacy, partly due to the low prevalence of this disease, so it is a future goal for the improvement of short stature in these patients.