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A remote rural municipality in northeastern Brazil, Itabaianinha used to be known as “a cidade dos anões”— the city of dwarfs. A century ago, marriage between close relatives was common here, which may explain the widespread hormonal deficit found among the town’s population.
In the late 1990s many residents of Itabaianinha began traveling to São Paulo to receive a new hormonal treatment that involves the absorption of growth hormone, causing the multiplication of cartilaginous cells at the bones’ extremities and allowing for increased growth. The treatment can only be applied to patients fifteen years and younger, because after puberty cartilage has already turned into bone. Nowadays, Itabaianinha’s population of dwarfs is disappearing, with only an estimated one hundred remaining, predominately in the small village of Carretéis, ten miles from Itabaianinha center.
Beatriz and Joana Nascimento are twin sisters living in Itabaianinha. These siblings, now seventy-two, were too old to receive the growth treatment when it first became available in Brazil, and thus are among the last dwarfs of Itabaianinha.
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