Pediatric Endocrinology
Short Stature and Growth Disorder
Growth development in human begins at conception. Proceeding through easy to
identify stages, both genetic and environmental factors influence the natural
height. The action of the growth hormone from the pituitary gland in particular,
heavily determines a normal or not growth path.
Standard Growth Chart
Remember, as a newborn, everyone begins at more or less the same size. Yet,
growth ends in a variety of different sizes. In order to monitor growth patterns
through the stages, doctors use a growth chart. This is an established range of
normal heights and weights for different age groups.
If a child ends up under the 3rd percentile or over the 97th growth
percentile for their age, doctors may look for evidence of growth problems,
growth hormone deficiency or hormonal growth disorders. This can include
familial short stature, chronic short stature or genetic short stature disorders.
Symptoms of Growth Disorder
Some of the symptoms of children with growth problems include:
- Fetal growth restriction
- Chronic Illness
- Malnutrition / Malabsorption
- Hypothyroidism
- Bone disorders
- Failure to Thrive (FTT)
Evaluation begins with birth history, past medical history, family history,
physical exam and growth patterns. Causes of Growth Disorder
Hormone producing glands spur human growth. The pituitary gland secretes the
actual growth hormone. This peanut shaped gland sits at the brain’s base.
Other hormones such as the thyroid gland in the neck, secrete hormones
essential for bone growth. A deficiency in any of these or other growth hormones
can result in a child with short stature.
Additional causes of short stature growth disorders may be due to
environmental deficiencies, disease or genetic mutations. The growth problems
may result from a pituitary growth hormone deficiency due to a genetic disorder.
Delay in growth can also be influenced by sex steroids and the thyroid
hormone. Children without any identifiable cause for their failure to grow have
idiopathic short stature. This means they’re unlikely to have a growth spurt and
catch up.
Treatment of Growth Disorders
The objective of growth hormone treatment in children is to improve the final
adult height. Human growth hormone therapy in combination with disease specific
remedies will generally improve short stature growth and the final adult height.
The growth hormone dose needs to be tailored to the child’s specific
condition and carefully monitored. The child may continue using this treatment
into adulthood to achieve normal peak bone mass although the maximum benefits
occur during the first year of treatment.
