[Pharmacologic treatment of constitutional short stature]

The term constitutional short stature is used to describe clinical situations characterized by low stature, assessed using special growth nomograms, but which are not due to specific endocrine alterations, nor to genetic causes or skeletal dysmorphisms, nor secondary to specific organ pathologies or chronic diseases. On the basis of this definition, our paper also includes the so-called normal variants of short stature (familial short stature and constitutional delay of growth) and intrauterine growth retardation. The endocrine and auxological features of constitutional short stature are described in the literature and provide an adequate basis for the use of therapies which include, in addition to growth hormone, substances capable of stimulating the endogenous secretion of the hormone (L-dopa, bromocriptine, clonidine, GHRH, pyridostigmine), or anabolic hormones. Biosynthetic growth hormone therapy is without doubt the most widely used, both on account of the extensive clinical experience and due to the easy availability of the drug made possible by the use of the biosynthetic molecule. Many subjects affected by constitutional short stature show a good response to hGH therapy, whereas others do not benefit by this treatment. New therapies using GHRH and neurodrugs, which are certainly easier to handle and less expensive, represent a new approach to the therapy of constitutional short stature but this condition still requires further investigation.