Short stature Flashcards
What is the definition of short stature?
Height that is two standard deviations below the mean compared with others of the same age and sex.
Name two non pathological causes of short stature?
- Familial short stature
2. Constitutional delay in growth and puberty
What is constitutional delay of growth and puberty?
Term describes temporary delay in skeletal growth thus delay in height with no physical abnormalities causing this delay.
- Growth chart shows reduced velocit around age 6 months and 3 years
- May return to normal in childhood
- Early adolescent - growth velocity is reduced again with delayed pubertal growth spurt which follows
Causes of short stature in babies and children? (3)
- Intra uterine growth restriction
- Nutritional deficiency
- Chronic illness - congenital heart disease
Disease which causes short stature in children? (5)
- Chronic illness - cystic fibrosis // inflammatory bowel disease
- Coeliac disease
- Hypothyroidism
- Growth hormone deficiency
- Skeletal dysplasia
Name two genetic causes of short stature?
- Down’s syndrome
2. Turner’s
Name 1 iatrogenic cause of short stature?
Steroid use
What are the component of examination? (3)
- Birth history + Birth weight (BMI)
- Dysmorphic features? or symptoms of chronic disease?
- diarrhoea ( IBD/ COELIAC )
- clubbing / heart murmur ( CONGENITAL HEART PROBLEM) - Pubertal staging
How is consitutional growth delay diagnosed? (2)
- Diagnosis is clinical ( no investigations necessary )
2. Bone age is usual to support the diagnosis
How is familial short stature diagnosed? (3)
- Diagnosis is clinical ( inv not needed)
- Serial growth measurement
- Plotting of mid parental height
Investigations of pathological short stature? (4)
- Radiograph to show bone ages
- Blood tests
- Growth hormone stimulation test to rule out growth hormone deficiency
- Genetic karyotyping to exclude Turner’s syndrome
What conditions cause delayed bone age? (4)
- Constitutional delay
- Hypothyroidism
- Growth hormone deficiency
- Chronic disease
What conditions cause advanced bone age? (3)
- Precocious puberty
- Hyperthyroidism
- Obesity in young kids
What blood tests can be done to investigate short stature? (5)
- Renal function tests
- FBC
- Inflammatory markers suggesting chronic disease like CKD
- Coeliac disease test
- Thyroid function test
Management of short stature? (2)
- No tx if constitutional delay or familial short stature
2. Synthetic growth hormone is given daily as a sub cut injection to promote growth
