Short Stature in Childhood - Challenges and Choices

and the Center for Child Health and Policy and the Division of Endocrinology and Diabetes, Rainbow Babies and Children's Hospital, Case Western Reserve School of Medicine, Cleveland (L.C.).
New England Journal of Medicine (Impact Factor: 55.87). 03/2013; 368(13):1220-1228. DOI: 10.1056/NEJMcp1213178
Source: PubMed


A family seeks evaluation and treatment of short stature in their 11.5-year-old son. He previously was in the 3rd percentile for height, but his growth rate has slowed during the past 2 years, and his height is now just below the 1st percentile (Fig. 1). His mother is 5 ft 0 in. (152 cm), and his father is 5 ft 6 in. (167 cm). The child's size at birth was normal. His medical history and a review of systems are unremarkable. His physical examination is normal and shows prepubertal development. The complete blood count, erythrocyte sedimentation rate, thyrotropin, tissue transglutaminase antibody, and insulin-like growth factor I (IGF-I) levels and growth hormone levels after provocative testing are normal. His skeletal maturation (bone age) is approximately 9 years, and his predicted adult height is 5 ft 5 in. (165 cm) plus or minus 1.3 in. (3.3 cm).(1) How should his condition be managed?

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