Causes of short stature identified in children presenting at a tertiary care hospital in Multan Pakistan

Abstract

Objective: To determine the frequency of common causes of short stature in children presenting to the Children’s Hospital & the Institute of Child Health, Multan. Methodology: This cross sectional study was done in Pediatric Endocrinology department, the Children’s Hospital & the Institute of Child Health, Multan, from March to September, 2011. One hundred and sixty nine children with short stature presenting to the outpatient department meeting inclusion criteria were recruited after taking an informed consent. The detailed history, physical examination including anthropometric measurements and relevant investigations were recorded. Causes of short stature (outcome variable) were recorded on a predesigned proforma for final analysis. Results: The common causes of short stature identified were; familial short stature (FSS) 36 cases (21.3%), hypothyroidism 29(17.2%), growth hormone deficiency (GHD) 18(10.7%), insulin dependent diabetes mellitus (IDDM) 16(9.5%) and constitutional delayed growth and maturation (CDGM) 11(6.5%) cases. This was followed by primary malnutrition 8(4.7%), celiac disease 6(3.6%),Turner syndrome 5(3%) cases and unknown syndromes 4(2.4%) followed by other rare causes. Conclusion: Common causes of short stature identified in this study were endocrine diseases followed by normal variant short stature (NVSS), while nonendocrine causes were the least.

Causes of short stature in Pakistani children found at an Endocrine Center

“…Primary hypothyroidism was seen in 9% (n=6) cases, while central hypothyroidism was present in only 1% in our study. Sultan et al in a Pakistani study reported hypothyroidism as a cause of short stature in 5.6% of their study population,14 while another local study by Rabbani et al reported it as 17% 15. Pan-hypopituitarism which is known to stunt growth was present in 6% of the patients, an Iranian study reported it as 3.5% 31.…”

Etiology of short stature in children attending pediatric endocrinology clinic of a tertiary care hospital in Bangladesh

“…In the present study 100 patients of short stature were enrolled, among them most common age group was 6-11 years, which is similar with other studies. 16,17 Present study had 47 males and 53 females. The male to female ratio was 0.92:1.…”

“…It is not similar with most of the studies done in different countries where males outnumbered the females. [17][18][19] Increased incidence of short stature in females in this study may be due to the fact that, there is increasing awareness among people about health seeking and most of the families have only 1-2 child. So, parents are giving similar emphasis on female and male child.…”

Short Stature in Children

“…Turner syndrome which is present in one of 2000 female alive birth infants, accounts for one out of 60 cases of female short stature (4) . If a chronic disease in childhood is severe enough, they can lead to growth failure and short stature and they include; renal, and cardiac diseases, malignancy, cystic fibrosis and celiac disease (20). Celiac disease can result in short stature by causing malnourishment (4) especially in young children (21) .…”