Related Experiment Videos
Management of children with short stature
Insights
Constitutional short stature/delayed puberty (CSS/DP) and growth hormone deficiency (GHD) are common causes of short stature in children. GHD treatment with human growth hormone (HGH) significantly increases growth velocity.
Area of Science:
- Pediatric Endocrinology
- Growth and Development
- Hormone Therapy
Background:
- Short stature is a common referral reason to pediatric endocrine clinics.
- Constitutional short stature/delayed puberty (CSS/DP) and growth hormone deficiency (GHD) are primary diagnoses.
- Understanding the presentation and treatment response is crucial for pediatric growth disorders.
Purpose of the Study:
- To analyze the causes and characteristics of short stature in referred patients.
- To evaluate the efficacy of human growth hormone (HGH) therapy in children with GHD.
- To compare presentation and pubertal timing between CSS/DP and GHD.
Main Methods:
- Retrospective review of 325 patients referred for short stature.
- Categorization of diagnoses including CSS/DP and GHD.
- Analysis of growth velocity pre- and post-HGH treatment.
Main Results:
- CSS/DP (50%) and GHD (26%) were the most frequent causes of established short stature.
- GHD patients presented earlier than CSS/DP patients, with bimodal peaks.
- HGH treatment significantly increased growth velocity in both complete and partial GHD.
- Male CSS/DP and GHD patients showed delayed mid-pubertal timing.
Conclusions:
- GHD and CSS/DP are the leading diagnoses for pediatric short stature.
- HGH therapy is effective in improving growth velocity for GHD patients.
- Delayed pubertal development is noted in males with CSS/DP and GHD.
Abstract:
325 patients referred to an endocrine clinic with short stature were reviewed, 32 (9.8%) were above the third centile for height and maintained normal growth velocities, fourteen (4.3%) have not had assessment completed. Of 279 children in whom the cause of short stature was established, 140 (50%) had constitutional short stature/delayed puberty (CSS/DP). Seventy-three (26%) had idiopathic growth hormone deficiency (GHD), complete in 23, while 66 patients (34%) had short stature due to other causes. Girls presented earlier (mean age 11.9) than boys (mean age 13.3) and GHD patients earlier than CSS/DP patients with bimodal peaks at 12 and 16 years. Male CSS/DP patients reached their mid pubertal point later than normal at 16.06 +/- 1.19 years (p less than .05) while in GHD males the mid pubertal age was 16.6 years (p less than .05). In female patients with short stature no significant pubertal delay was observed. The average growth velocity of complete GHD patients pre treatment was 3.7 cms/year. Velocity rose to 6.2 cms/year on human growth hormone (HGH) extract and rose further to 8.1 cms/year on biosynthetic HGH. In partial GHD patients the average pre-treatment velocity of 4.3 cm/year rose to an average of 6.0 cm/yr on HGH extract and maintained this velocity on biosynthetic HGH.