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- Laurie R. Braun, MD*,†
- Rose Marino, MD*
- *Pediatric Endocrine Unit and
- †Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA
AUTHOR DISCLOSURE
Dr Braun has disclosed that she receives grant funding from National Institutes of Health T32HD052961-10. Dr Marino has disclosed no financial relationships relevant to this article. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device.
- ACTH:
- adrenocorticotropic hormone
- CDC:
- Centers for Disease Control and Prevention
- CDGP:
- constitutional delay of growth and puberty
- CNS:
- central nervous system
- FSS:
- familial short stature
- GH:
- growth hormone
- GnRH:
- gonadotropin-releasing hormone
- IGF-BP3:
- IGF-1 binding protein 3
- IGF-1:
- insulin-like growth factor 1
- ISS:
- idiopathic short stature
- NPR2:
- natriuretic peptide receptor B
- rhGH:
- recombinant human GH
- SGA:
- small for gestational age
- SHOX:
- short stature homeobox
- TSH:
- thyroid-stimulating hormone
- T4:
- thyroxine
Education Gap
It is often challenging to identify children with abnormal growth patterns and distinguish normal growth variants from pathologic variants.
Objectives
After completing this article, readers should be able to:
Perform growth measurements and interpret growth charts to be able to identify children with short or tall stature.
Differentiate among the common origins of short and tall stature and plan an appropriate diagnostic evaluation for a slowly or rapidly growing child.
Describe when treatment is indicated for children with short and tall stature.
Introduction
Growth parameters are routinely measured in general pediatrics, with the goal of identifying children with abnormalities in growth and stature. Short stature is defined as a height less than 2 standard deviations (SDs) below the mean of the “normal” population, while tall stature is defined as a height greater than 2 SDs above the mean of the normal population. Both single growth measurements and the pattern of growth over time (growth velocity) are useful in identifying children with abnormal stature. The growth velocity changes over time, with relatively rapid growth in infancy and early childhood, followed by slower growth (approximately 5 cm per year) in later childhood and then rapid growth again during puberty. There is a range of pubertal peak growth velocities of around 7 to 12 cm per year and 6 to 10.5 cm per year in boys and girls, respectively, representing approximately the 3rd to 97th percentiles. The timing of peak growth velocity varies with the age of puberty onset and frequently reflects familial pubertal and growth patterns. Overall, it is thought that …
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