Growth and Puberty: Tall Stature

Question 1

Is tall stature a more or less common presenting complaint than short stature?

Answer 1

Less

Question 2

What is the most common cause?

Answer 2

Familial e.g inherited from tall parents

Question 3

How does obesity affect stature?

Answer 3

Obesity can fuel early growth and may result in tall stature, but puberty is often earlier than average - so final height centile is less than in childhood

Question 4

What secondary endocrine causes are there?

Answer 4

Hyperthyroidism
Excess sex steroids - precocious puberty
Excess adrenal androgen steroids - congenital adrenal hyperplasia
True gigantism - excess GH secretion

PP and CAH lead to early epiphyseal fusion - eventual height is reduced after early excessive growth rate

Question 5

What syndromes cause long legged tall stature?

Answer 5

Marfan syndrome - disorder of loose CT
Klinefelter (47XXY) - an excess of SHOX
Homocystinuria

Question 6

Excessive height in prepubertal and early pubertal adolescent females and males can be treated with…

Answer 6

Oestrogen and testosterone therapy respectively - induce premature fusion of epiphyses