An aetiological evaluation of short stature

Abstract

Background: Short stature can be a normal variant or secondary to an underlying disorder. It is necessary to evaluate short stature to differentiate a normal from pathological short stature and thus decide the further treatment needed. This study was conducted at a tertiary care hospital to find out the various etiologies of short statureMethods: An observational study was conducted on 49 children in age of 2-12 years with short stature. They were grouped as normal variants and pathological short stature depending on upper-lower segment ratio the study group was later divided into proportionate and disproportionate short stature. They were further investigated to find out the etiology of the short stature. The bone age of all groups was compared with the chronological age to calculate the bone age retardation.Results: Out of 49 children 26.5% were normal variants and 73.4% as pathological type. 77.7% of pathological short stature were proportionate type. The male:female ratio was 1:1.4. Chronic systemic disorders were detected in 24.48% while malnutrition and endocrine disorders constituted 12% each. The bone age retardation in endocrine disorders was 0.47.Conclusions: Chronic systemic disorders were commonest cause of pathological short stature in this study. Females were predominantly affected in all groups and bone age retardation was maximum in endocrine disorders, thus indicating that early diagnosis and management of these disorders is necessary to decrease the growth retardation in these children. An understanding of short stature not only permits to differentiate a normal variant from an underlying disorder but also helps in modifying the course by means of early intervention.

Etiological Study of Short Stature among Children Attending Outpatient Department of Pediatrics in a Tertiary Care Medical College Hospital

“…In our study the endocrine causes for short stature was 18% whose findings are consonant with other research like Rabbani et al (15.9%) and Phirke (12.24%). [1,14] Endocrine causes were low in Shiva ) which are conflicting to our study. [15,19,20,[24][25][26] This may be due to the difference of study settings where each study is being done.…”

“…In our study, among pathologic short stature, malnutrition (9%) was found to be the most common non endocrinological cause. These results were consistent with [14,[23][24][25]27,28] Other causes like genetic syndrome constitute 5 % of short stature which is in consonant with many Indian studies done by Bhadada et al (7.4%), Phirke et al (4%) and Deep Dutta et al(8%). [14,18,27] The shortcomings of this study include failure to calculate and plot growth velocity which requires a regular follow-up at six months to twelve months interval, which was not possible in this cross-sectional study.…”

“…). [1,14,20,23,17,18,19,27,25] Most of these studies are being done in endocrine clinic of tertiary hospitals where more of endocrinologic causes will be encountered. Endocrine disease was one of the causes of pathological short stature in child and it was found to be high in females than males with 31% and 10% respectively (P<0.01).…”

“…[23] Growth hormone deficiency accounted for only 2% of short stature in our study. 18 12.4% -Hussain A etal 15 -26% Ganavi ramgopal 10% 24% Phirke s d etal 14 24.48% 12.24% Deep Dutta 27 1% Garg et al 24 40% 4.7% Colaco et al 25 8.4%…”

An Integrated Approach to Management of Short Stature in Children: Review Article

“…Among them, 24% had systemic cause where as malnutrition and endocrine cause was found in 12 % each. 15 The infancy phase of growth which has been assumed to begin at mid gestation and taper off around 2 to 3 years is regarded as predominantly nutrition dependent.11 Malnutrition at this phase of growth can lead to stunted growth.…”