20 SHORT STATURE Common complain Symptom not a disease Important to differentiateNormal variantPathologic short statureGenetic/familialConstitutional delay of growthProportionateDisproportionate
21 SHORT STATURE NORMAL VARIANTS Normal growth velocity Familial short statureFamily history of short statureNormal growth velocityNormal bone ageConstitutional delay of growth and pubertyFamily history of similar growth pattern but average to tall final heightLow normal growth velocityDelayed bone age
23 SHORT STATURE PATHOLOGIC Uncommon, mostly due to skeletal dysplasias: DisproportionateUncommon, mostly due to skeletal dysplasias:achondroplasia or dyschondroplasiahypophosphatemic ricketsProportionate Short statureMost common, etiology prenatal or postnatal
34 26 months old boy 97% 50% 3% PE: Child small for age, Proportionate, no abnormal features,wears glasses, rest of exam WNL50%3%
35 Prevalence of growth hormone deficiency: Utah Growth Study 114,881 children studiedGHD: height >2 SD below mean,growth rate<5 cm/yr,delayed bone maturation,peak GH<10ng/mL16 new cases identifiedPrevalence 1:3480Lindsay R. J. Pediatr 1994;125:29-35
36 Growth hormone deficiency 1 in 4000 children, 1% of “short” childrenClinical characteristics-short stature-chubby face, truncal obesity-delayed skeletal maturation-high-pitched voiceEtiology: idiopathic vs organic
42 Take Home Message Short stature is a symptom not a disease Etiology could be normal variant or pathologicCareful and specific H/P and laboratory testing will guide you to the diagnosis and appropriate managementGrowth rate determination and accurate measurements important
Your consent to our cookies if you continue to use this website.