Growth failure in adolescents: etiology, the role of pubertal timing and most useful criteria for diagnostic workup

Abstract

In adolescents, pathological causes for growth failure and pubertal delay are common, and we recommend a combination of height SDS, distance to THSDS and growth deflection for deciding on further diagnostic testing.

A Proposal for the Interpretation of Serum IGF-I Concentration as Part of Laboratory Screening in Children with Growth Failure

“…The reported prevalence of GHD in children referred for GF to a paediatric (endocrine) clinic also varies. In Dutch studies the prevalence was between 0.5-3% (24,25,26) and in other studies prevalences between 0 and 23% were reported (27,28,29,30,31,32,33,34). For this analysis we estimated the general prevalence of GHD in children referred for GF at 2%, in line with a recent publication (35), but this percentage may differ between a general and academic paediatric clinic.…”

A Novel IGSF1 Mutation in a Boy With Short Stature and Hypercholesterolemia: A Case Report

“…As the most common cause of delayed puberty, CDGP is associated with slow growth, delayed bone age, and a positive family history. When there are clues for disturbed growth, but not for a specific diagnosis, further investigations are advised [ 9 ]. When delayed pubertal growth acceleration is accompanied by large testes, IDS should be suspected.…”

Clinical benefits of sex steroids given as a priming prior to GH provocative test or as a growth‐promoting therapy in peripubertal growth delays: Results of a retrospective study among ENDO‐ERN centres

“…Inclusion criteria were as follows: age 11‐14 years for males or 10‐13 years for females; Tanner stage < −1 SDS according to puberty nomograms; and 13 bone age no greater than chronological age. Exclusion criteria were as follows: born small for gestational age; familial short stature; obesity or severe malnutrition; chronic diseases or steroid use; combined pituitary hormone deficiencies; syndromic patients; history of intracranial or systemic tumours; midline brain defects; and signs of skeletal dysplasia.…”

“…Patients were diagnosed as isolated growth hormone deficiency (GHD) if peak GH upon GHST was < 8 µg/L, possibly together with IGF-1 concentrations below two Standard Deviation Score (SDS). Among subjects with peak GH ≥ 8 µg/L, diagnosis of CDGP was established if puberty had not started yet or had a slow or stuttering progression (defined as Tanner stage < -1 SDS according to puberty nomograms) associated with at least two of these criteria; i) bone age delay > 1 year compared to chronological age; ii) being short for target height (TH); and iii) family history of pubertal delay 13…”