Short stature
Defined as a height 2 SDs or more
below mean for the population. On a standard growth chart this represents a
height below the 2nd centile. Note: abnormalities
of growth may be present long before height falls below this level and can be identified much earlier by monitoring
growth velocity and observing a child’s height crossing centile lines plotted.
The most common cause is
famil-ial, where either one or both parents will also be short. Height
correlates well with parental height and is probably of polygenic inheritance,
but it should be noted that short parents may have a dominantly inherited
growth disorder.
Pregnancy
illness/drugs/complications
· Gestational age and complications
· Birth weight (length and head
circumference)
· Feeding and weight gain
Chronic asthma
Corticosteroids
Headaches/visual disturbance
Examine previous growth records if
available
· Developmental delay.
· School performance.
· Short stature/pubertal delay.
· Endocrine disease.
· Measure height; weight; head
circumference.
· General systems examination.
· Puberty (Tanner) staging.
· Observe for goitre; dysmorphic
features; malnutrition.
· Assess growth velocity over (a
minimum of) 6-monthly intervals.
Measure parent’s height and
calculate MPH and family height target.
The following baseline screening
tests should be carried out:
·U&E (renal function).
·FBC and CRP (chronic
disease/inflammation).
·Calcium and phosphate (bone
disorder).
·Karyotype (chromosomal
abnormalities, especially Turner’s syndrome).
·Thyroid function tests.
·Serum IGF-I (and IGFBP-3) (GH
deficiency).
·Coeliac disease antibody screen.
·Urinalysis.
Where clinically indicated:
·Bone age X-ray.
·GH provocation test.
This will depend on the underlying
cause. The diagnosis of a child with short stature is often a shock to the
family, and they should be offered detailed, reliable information about their
child’s condition and informed where to get additional support and advice. In
the UK the Restricted Growth Foundation (www.restricted-growth.co.uk) is a good resource. Familial short
stature does not require any specific treatment.
Related Topics
Privacy Policy, Terms and Conditions, DMCA Policy and Compliant
Copyright © 2018-2023 BrainKart.com; All Rights Reserved. Developed by Therithal info, Chennai.