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Evaluation of short stature in children
Insights
A study evaluated 429 children for short stature, finding 57% were small. Of these, 32% had growth-retarding diseases, with hypopituitarism being common in this endocrine clinic setting.
Area of Science:
- Pediatrics
- Endocrinology
- Genetics
Background:
- Short stature affects a significant number of children referred to specialized clinics.
- Identifying the underlying causes of growth issues is crucial for timely intervention.
Purpose of the Study:
- To evaluate the causes of short stature in children referred to an endocrine clinic.
- To determine the prevalence of healthy short stature versus pathological growth retardation.
Main Methods:
- Retrospective analysis of 429 children evaluated for short stature over one year.
- Assessment included age at consultation, height measurements (standard deviation scores), and evaluation for underlying diseases.
- Bone age assessment was performed in a subset of patients.
Main Results:
- 57% of evaluated children presented with short stature (below -2 SDS).
- 32% of children had endocrine or nonendocrine diseases causing growth retardation; 68% were considered healthy.
- Retarded bone age was more prevalent in significantly short children (65%) compared to those within normal height limits (28%).
- Hypopituitarism was diagnosed in 15 patients, reflecting the clinic's specialization.
Conclusions:
- Short stature in children has diverse etiologies, ranging from constitutional delay to significant underlying pathologies.
- Endocrine disorders, particularly hypopituitarism, are a notable cause of growth retardation in specialized pediatric endocrine settings.
- Comprehensive evaluation, including bone age assessment, is essential for differentiating healthy short stature from disease-related growth failure.
Abstract:
Within a year 429 children referred for short stature have been evaluated. The age at consultation ranged from 5 months to 17 1/2 years. Healthy but small children came at 5 to 7 and 10 to 13 years, while those with different pathologies attended the clinic at all ages. The stature of 43% of the investigated children ranged within normal limits (till -2 SDS), while 57% had a small stature. 68% of the children could be considered healthy, 32% had different endocrine and nonendocrine diseases responsible for their growth retardation. Retarded bone age (greater than 2 SD below the mean) was observed in 65% of the significantly short but otherwise healthy children and in only 28% of the healthy children with heights above -2 SD. Extreme short stature was mainly associated with a recognized disease of chronic and genetic origin, low birthweight and malnutrition. The high incidence of hypopituitarism (15 patients) is due to the fact that this study was performed in an endocrine clinic.