Clinical Dilemmas in Evaluating the Short Child

Garganta, Melissa D.; Bremer, Andrew A.

doi:10.3928/00904481-20140723-11

Cited by 13 publications

(17 citation statements)

References 23 publications

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“…GHD can only be diagnosed after extensive diagnostic procedures such as growth hormone (GH) stimulation tests [2,3,4,5]. Additionally, the cost-effectiveness in the differential diagnosis of short stature has so far been low [10].…”

Section: Introductionmentioning

confidence: 99%

“…Growth hormone deficiency (GHD) typically manifests at the age between 4 and 8 years presenting with growth failure, retarded bone age, and low serum levels of IGF-1 [1,2]. GHD has to be distinguished from other chronic diseases and especially from norm variants associated with short stature [2,3,4,5]. The most frequent underlying norm variants of short stature accounting for ∼80% of all cases visiting a pediatric endocrinologist are familial short stature (FSS) and constitutional delay of growth (CDG) [2].…”

Section: Introductionmentioning

confidence: 99%

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Progressive Decline in Height Standard Deviation Scores in the First 5 Years of Life Distinguished Idiopathic Growth Hormone Deficiency from Familial Short Stature and Constitutional Delay of Growth

Rothermel

Lass²,

Toschke³

et al. 2016

Horm Res Paediatr

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Background: Familial short stature (FSS) and constitutional delay of growth (CDG) are the most frequent norm variants in children presenting with short stature. Knowing the growth patterns of these entities in the first years of life might be helpful to distinguish them from growth hormone deficiency (GHD) or other chronic diseases. Methods: We studied the height in the first 5 years of life in 26 children with FSS, in 38 children with CDG and in 14 children with idiopathic GHD. Results: Height standard deviation scores (SDS) did not change between birth and 6 months of life, while height SDS decreased significantly afterwards in GHD, FSS, and CDG. The loss of height SDS was higher in the first 2 years of life than between 2 and 5 years of life in children with CDG (-0.92 vs. -0.11; p = 0.003) or FSS (-0.79 vs. -0.01; p = 0.002). In idiopathic GHD, the loss of height SDS did not differ between the first 2 years of life and the next 3 years (-0.78 vs. -0.77; p = 0.821). Conclusion: Children with FSS and CDG showed a decline in height SDS mainly in the first 2 years of life, whereas the height SDS of children with idiopathic GHD decreased almost continuously over the first 5 years of life.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Progressive Decline in Height Standard Deviation Scores in the First 5 Years of Life Distinguished Idiopathic Growth Hormone Deficiency from Familial Short Stature and Constitutional Delay of Growth

Rothermel

Lass²,

Toschke³

et al. 2016

Horm Res Paediatr

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“…Changes in growth velocity can be seen when reviewing a child's growth chart. Exact height measurements should be charted at all visits to observe and calculate a height rate (Garganta and Bremer, 2014). Therefore, plotting measurements on a growth chart is essential for recording a child's longitudinal development in size (National Center for Health Statistics, 2007).…”

Section: Discussionmentioning

confidence: 99%

Idiopathic Short Stature in Children: A Hospital Based Study

Alharthi¹

2016

J. of Medical Sciences

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“…Several studies reported improved emotional and social functioning of GH‐treated children, while others found no change following GH therapy . In their systematic review, Gardner et al proposed that the inconsistency of the psychosocial outcomes may stem from methodologic flaws: referral bias, small numbers of participants, absent/inadequate control groups, lack of blinding and the relatively poor sensitivity of the explicit tools used to evaluate psychological functioning …”

Section: Introductionmentioning

confidence: 99%

Growth hormone therapy and short stature‐related distress: A randomized placebo‐controlled trial

Shemesh-Iron

Lazar

Lebenthal

et al. 2019

Clinical Endocrinology

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Summary Context Growth hormone (GH) treatment of short healthy children is based on the belief that short stature is associated with psychosocial problems and a diminished quality of life. Objective To determine the impact of GH therapy on psychosocial well‐being and the ability of psychological metrics to define short stature‐related distress. Methods Sixty prepubertal boys with idiopathic short stature (age: 10.0 ± 1.4 years, height‐SDS: −2.38 ± 0.3) were enrolled in this 4‐year intervention study (1‐year double‐blinded, randomized, placebo‐controlled [GH/placebo‐2:1] and 3‐year open‐labelled GH therapy). Explicit (conscious/voluntary) psychological metrics (Pediatric Quality of Life Inventory [PedsQL], Silhouette Apperception Test [SAT], Rosenberg Self‐Esteem Scale [RSES], Child Behavior Checklist [CBCL]) and implicit (unconscious/involuntary) psychological metrics (Single‐Category Implicit Association Test for height [SC‐IAT‐H], Height Perception Picture Test [HPPT]). Psychosocial evaluations were performed at study entry, after 1 and 4 years. Results At study entry, PedsQL of boys with idiopathic short stature was lower than Israeli norms (P = 0.001). After 1‐year blinded intervention, only the GH‐treated boys improved their actual and anticipated adult height perception (SAT, P < 0.001 and P = 0.022) with reduced short stature‐related distress (SC‐IAT‐H, P < 0.001). At study end, RSES and SC‐IAT‐H improved significantly (P < 0.001), with no change in PedsQL and CBCL. Conclusions Our finding of improved psychosocial functioning only in the GH‐treated boys after 1‐year blinded intervention suggests that it was the GH therapy, rather than being enrolled in a clinical trial, which contributed to the outcome. Long‐term open‐labelled GH treatment significantly improved height perception and self‐esteem. Future studies are needed to fully assess the relevance of complementing the routinely used explicit self‐report measures with the implicit measures.

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Clinical Dilemmas in Evaluating the Short Child

Cited by 13 publications

References 23 publications

Progressive Decline in Height Standard Deviation Scores in the First 5 Years of Life Distinguished Idiopathic Growth Hormone Deficiency from Familial Short Stature and Constitutional Delay of Growth

Progressive Decline in Height Standard Deviation Scores in the First 5 Years of Life Distinguished Idiopathic Growth Hormone Deficiency from Familial Short Stature and Constitutional Delay of Growth

Idiopathic Short Stature in Children: A Hospital Based Study

Growth hormone therapy and short stature‐related distress: A randomized placebo‐controlled trial

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