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Treatment of children and adolescents with idiopathic short stature

Michael B Ranke1

  • 1University Children's Hospital Tübingen, Hoppe-Seyler-Strasse 1, D-72076 Tübingen, Germany. michael.ranke@gmx.de

Nature Reviews. Endocrinology
|April 24, 2013
PubMed

Insights

Idiopathic short stature (ISS) treatment options include counseling and medical interventions. Growth hormone therapy is approved for children with ISS, though optimal dosing and long-term safety require further research.

Area of Science:

  • Pediatrics
  • Endocrinology
  • Genetics

Background:

  • Idiopathic short stature (ISS) is characterized by childhood shortness without a clear underlying cause.
  • ISS can be familial or nonfamilial and may present with or without delayed puberty.
  • Psychological burden associated with short stature necessitates treatment considerations.

Purpose of the Study:

  • To review current and experimental treatment modalities for idiopathic short stature.
  • To discuss the efficacy and limitations of various therapeutic approaches, including growth hormone therapy.
  • To address the ongoing debate regarding the psychological benefits versus medicalization of height increase.

Main Methods:

  • Review of existing literature on idiopathic short stature treatments.
  • Analysis of hormonal therapies, including sex steroids, GnRH agonists, aromatase inhibitors, and growth hormone.
  • Examination of evidence regarding effects on height velocity, growth tempo, and adult height.

Main Results:

  • Sex steroids can improve height velocity but do not affect adult height.
  • Experimental medications like GnRH agonists and aromatase inhibitors may increase adult height.
  • Growth hormone therapy is approved for ISS and can increase height, but requires higher doses than replacement and needs optimization for efficacy, cost, and safety.

Conclusions:

  • Growth hormone therapy is an established treatment for ISS, though optimization is needed.
  • Experimental therapies show potential but require further investigation.
  • A critical discussion on the psychological benefits and potential medicalization of height is ongoing.

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