Characteristics and etiologies of short stature in children

Abstract

Background: Short stature is a common reason for referral to pediatric endocrinology clinics. It may be a manifestation of a pathological condition requiring early treatment. The aim of this study was to describe the characteristics and etiologies of short stature among children referred to the pediatric endocrinology clinic of the main pediatric tertiary care center in Tunisia. Methods: Retrospective and descriptive study in the endocrinology unit of children referred for short stature between January 2012 and December 2016. Data on the patients' medical history, physical findings, laboratory tests, bone age and chromosomal analysis were collected. Results: 470 children (266 males and 204 females) were referred during that period. 214 (45.5%) had normal height, and 80.8% of them were referred by general practitioners. The other 256 children (54.5%) had a confirmed short stature (mean age :7.2 years, mean height: -2.77 SDS). Endocrinological causes were the most common(43% GHD, 4% hypothyroidism) followed by intrauterine growth retardation IUGR (24%), genetic syndromes (8.4%), chronic pediatric diseases (7.8%), skeletal dysplasia (6.2%), normal variant of short stature (5%), and psychosocial deprivation (1.2%). Among non-endocrine causes, Turner syndrome was the most common genetic syndrome (4.4%), achondroplasia the main skeletal dysplasia (4%) and celiac disease the main chronic disease (3.4%). Conclusions: ST is largely overestimated in our country. Therefore, it is important to insist on adequate measurement and analysis of growth parameters to avoid unnecessary investigations. GHD and IUGR were the most common causes. Celiac disease, though frequent in Tunisia, is not a common cause of short stature.

Factors influencing stunted growth in children: A study in Bandung regency focusing on a deworming program

“…Many developing countries (Jordan, Cameroon, Pakistan, and Palestine) with lower economic development and living standards than Indonesia have lower prevalence rates of stunting (5%–10%) ( Jawa et al, 2016 ; Essaddam et al, 2020 ; Monteiro et al, 2024 ), which further supports our assumption that malnutrition is not the main factor causing stunting among the children of the Bandung Regency. However, we recognize the negative impact of undernutrition and poor environmental conditions on the development of disadvantaged subgroups of children, and our results show statistically significant differences in socioeconomic indices between short- and normal-stature children, and between underweight and overweight/obese children.…”

“…In a study in Riyadh of 110 patients, 57 (51.8%) were found to have genetic short stature, while endocrine and nutritional causes were found to contribute to short stature in the remaining 53 (48.2%) ( Short stature in children, 2012 ). In contrast, familial short stature was a minor cause of short stature (<5%) in a large case series with participants from other countries ( Jawa et al, 2016 ; Essaddam et al, 2020 ).…”

Prevalence and socioeconomic correlates of growth impairment among Saudi children and adolescents

“…[ 25 ] Furthermore, several developing countries (e.g. Jordan, Cameron, Pakistan, Palestine) with much lower economic development and living standards than Saudi Arabia scored lower prevalence rates of short stature (5%–10%),[ 23 24 26 ] which further supports our assumption that undernutrition is not the major player leading to short stature among Saudi children and adolescents. Thus, we acknowledge the negative impact of low SES on the growth of a subgroup of socioeconomically disadvantaged children with subsequent nutritional deprivation and poor environmental conditions, as evidenced by the statistically significant differences in socioeconomic indices between short- versus normal-stature children and adolescents, and thin versus overweight/obese children and adolescents.…”

“…[ 22 ] In contrast, familial short stature was a minor cause of short stature (<5%) in a large case series with subjects from other countries. [ 23 24 ] The high rate of consanguineous marriages in Saudi Arabia (up to 50%–60%) could explain the high rate of familial short stature. [ 25 ] Furthermore, several developing countries (e.g.…”