Duke Medicine: Short stature in children
Sometimes a child's height is influenced by more than just genetics. Dr. Nancie MacIver Duke Pediatrics Division of Endocrinology explains how doctors assess short stature in children and when something can be done about itPosted — Updated
Short stature is one of the most common reasons for referral to a pediatric endocrinologist. It is our job to decide whether there is a medical reason for the child’s short stature, and to provide referral, guidance, or treatment as indicated.
The first step in evaluation of a child with short stature is to review the medical and family history with the child’s parents or caregivers. This should include review of growth patterns since birth and consideration of any past or present medical problems the child may have.
In addition, the heights of immediate family members, particularly those of the parents, are important in the evaluation of a short child.
There are two “physiologic” causes of short stature that are commonly encountered in our clinic. Physiologic causes are those not associated with any disease or illness.
The first is familial short stature. Simply stated, if a child’s parents are short, the child is likely to be short as well, because height is an inherited trait.
The second common physiologic cause is constitutional delay, a.k.a. the “late bloomer.” Children with constitutional delay will usually enter puberty later than their peers, and have a delay in the onset of their pubertal growth spurt. However, these children will eventually catch up to their peers and grow to a normal adult height.
Once the physiologic causes have been excluded, there are several hormonal causes of short stature that need to be considered when evaluating a short child. They include disorders of growth hormone secretion or action and deficiency of thyroid hormone.