Short stature (height) is defined as height less than 2 to 2.5 standard deviations (SD) below the mean for age. However, decreasing growth velocity is very important regardless of absolute height.
It is important to distinguish normal (constitutional or familial) short stature from that due to a medical problem.
Short stature must also be distinguished from failure to thrive (FTT), with associated poor weight gain.
If the child has decelerating growth patterns or is significantly short (#2 SD), further evaluation should be guided
by the clinical findings.
In general, however, weight for age less than height for age may indicate chronic illness or malnutrition,
and weight for age greater than height for age may indicate endocrine disorders or genetic disorders and syndromes.
The common causes of short stature :
–Familial short stature:
Normal pubertal development, (Bone age = chronological age).
–Constitutional growth delay:
Pubertal delay,( Bone age = height age), (Bone age < chronological age).
— Malnutrition.
— Malabsorption.
— Diabetes mellitus. (poorly controlled) .
— Celiac disease.
— Chronic illness: Cystic fibrosis, Sickle cell disease, Cardiac disease,
Renal dysfunction, Severe asthma, inflammatory bowel disease Psychosocial dwarfism (may retard growth and
mimic hypopituitarism).
— Endocrine causes:
Hypothyroidism, Growth hormone deficiency, Cushing syndrome,
Precocious puberty, Diabetes mellitus, Rickets.
— Syndromes/genetic disorders/ Skeletal dysplasia.
How can we approach to the short stature?
The first step in the evaluation of a child with suspected short stature is to obtain accurate measurements and plot them on the appropriate growth chart.
When the child is diagnosed to have “Short stature”, wide Laboratory investigations should be done to roll out the underlying cause. Such as:
Bone age, CBC , Chemistry profile, Urine study, Celiac panel, Thyroid function test, Growth hormone study, Cortisol study, Karyotype , Sweet chloride test, Stool study… etc. according to the suspicion.
Once the tests have been performed, then the management will be decided.
If you would like to book an appointment with our Pediatric Specialist Dr Bahaa Abdulhai,
Call 04 3990022 or #BookOnline: https://armadahospital.com/book-online/