Short Stature in Children: A Practical Approach for Primary Care Providers

Cakan, Nedim; Kamat, Deepak

doi:10.1177/0009922806290597

Cited by 13 publications

(9 citation statements)

References 31 publications

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“…Relevant points in the history include birth characteristics, symptoms suggestive of chronic organic diseases, psychiatric diseases and/or severe emotional disturbances (table 2) [2,21,22]. The physical examination should aim at detecting clues for one of the many causes of short stature.…”

Section: Diagnostic Proceduresmentioning

confidence: 99%

Diagnostic Approach in Children with Short Stature

et al. 2009

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For early detection of pathological causes of growth failure proper referral criteria are needed, as well as a thorough clinical, radiological and laboratory assessment. In this minireview we first discuss the two consensus-based and one evidence-based guidelines for referral that have been published. The evidence-based guidelines result in a sensitivity of approximately 80% at a false-positive rate of 2%. Then, relevant clues from the medical history and physical examination are reviewed, and specific investigations based on clinical suspicion listed. In the absence of abnormal clinical findings, an X-ray of the hand/wrist and a laboratory screen are usually performed. Scientific evidence for the various components of laboratory screening is scarce, but accumulated experience and theoretical considerations have led to a list of investigations that may be considered until more evidence is available.

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Section: Diagnostic Proceduresmentioning

confidence: 99%

Diagnostic Approach in Children with Short Stature

et al. 2009

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“…Short stature is one of the most common causes of referral to pediatric endocrinology clinics. 1 Altered growth potential may result from disturbances of the endocrine system, altered nutrition or chronic diseases. 2 Adult height is largely genetically predetermined, and height variations can be explained by genetic factors, although environmental factors also play a pivotal role.…”

Section: Introductionmentioning

confidence: 99%

Etiological factors of short stature in children and adolescents: experience at a tertiary care hospital in Egypt

Hussein

Farghaly

Askar

et al. 2017

Therapeutic Advances in Endocrinology

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Background: Accurate anthropometric measurements and critical analysis of growth data allow the clinician to promptly recognize children with short stature. The aim of this study was to determine the frequency of etiological factors causing short stature among children referred to the pediatric endocrinology clinic of Assiut University Children's Hospital, the main tertiary care center in Upper Egypt. Methods: We conducted this descriptive observational study from May 2012 to December 2015, to analyze 637 children (boys 354, girls 283) with short stature. Evaluation included: detailed medical history, physical examination, laboratory tests, bone age and chromosomal analysis. Results: Endocrinological causes accounted for 26% of short stature [of them, 11.8% had growth hormone deficiency (GHD)], 63.6% had normal variants of growth [of them, 42% had familial short stature (FSS), 15.8% had constitutional growth delay (CGD) and 5.5% a combination of both]. Interestingly, celiac disease (CD) constituted 6.6% of children with short stature in our cohort. Conclusions: Although potentially treatable causes such as GHD, hypothyroidism and CD accounted for a considerable percentage of short stature in our study, the majority of short stature in children had normal variations of growth. Growth hormone treatment in children, however, should be promptly initiated with specific clinical indications. CD is a not uncommon cause of short stature.

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“…Short stature or a lower than normal growth rate can be the first and sometimes the only manifestation of a variety of congenital and acquired diseases among the pediatric population [1]. Amongst these diseases are Turner syndrome [2], celiac disease [3], inflammatory bowel disease [4], and endocrine disorders such as hypothyroidism [5] and growth hormone deficiency (GHD).…”

Section: Introductionmentioning

confidence: 99%

Ethnic and Gender Inequities in the Evaluation of Referred Short Children

Yardeni

Loewenthal²,

Limony³

et al. 2011

Horm Res Paediatr

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Aims: To examine ethnicity and gender differences in the evaluation of referred children with short stature and to investigate adherence of the primary care evaluation to published guidelines. Methods: Cross-sectional study in a referral center. 371 short patients aged 2–18 years were included. Outcome measures were patient’s growth characteristics, final diagnosis, and prevalence of pre-referral patient data. Results: The study population was composed of 239 Bedouin children and 132 Jewish children (p < 0.0001). More males (61%) than females were evaluated (p < 0.0001). There were no significant differences between males and females in age and growth parameters at the time of referral. Bedouins, males and females, were significantly shorter than their Jewish counterparts at the time of referral: height SD –2.44 ± 0.73 and –2.62 ± 1.05 versus –2.13 ± 0.55 and –2.21 ± 0.57, respectively (p < 0.05). There were no significant ethnic or gender differences in the final diagnosis. Significant deficiencies in the primary care evaluation of referred short children were found. Conclusions: We demonstrated novel ethnic- and gender-based inequities in the evaluation of referred short children. We found that the current evaluation of short stature in our area does not comply with existing guidelines.

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Short Stature in Children: A Practical Approach for Primary Care Providers

Cited by 13 publications

References 31 publications

Diagnostic Approach in Children with Short Stature

Diagnostic Approach in Children with Short Stature

Etiological factors of short stature in children and adolescents: experience at a tertiary care hospital in Egypt

Ethnic and Gender Inequities in the Evaluation of Referred Short Children

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