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A representative growth chart for a child with celiac disease. Figure 3. A representative growth chart for a child with acquired hypothyroidism. 

A representative growth chart for a child with celiac disease. Figure 3. A representative growth chart for a child with acquired hypothyroidism. 

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Concerns about a child's growth are one of the most common topics parents voice during general pediatric office visits and are a leading cause for referral to a pediatric endocrinologist. There are a variety of conditions that lead to short stature in children; however, in the absence of true pathology, idiopathic short stature and constitutional d...

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... in growth velocity can be seen when reviewing a child's growth chart. Accurate height measurements should be plotted at all visits to observe and calculate a height velocity. A child's height should be measured using a sta- diometer and proper technique; this in- cludes measuring a recumbent length for children younger than age 2 years using a fixed headboard and movable foot- board and standing height for children older than 2 years. 10 Often the patient's height is measured inaccurately, which can falsely appear as short stature when viewed on the growth chart. In fact, it has been estimated that only 30% of children seen in primary care offices are measured using the proper technique, and that on average, there is a 2.2-cm difference in measured length between proper stadiometer use and simple tape measure use. 10,11 Short stature due to poor nutrition or gastrointestinal ill- nesses typically demonstrate a decrease in weight gain followed by a decrease in height velocity (Figure 2). In contrast, the typical growth pattern of a child with an endocrinopathy causing short stat- ure, such as hypothyroidism or growth hormone deficiency, reveals a decrease in linear growth velocity with normal or increased weight (Figure 3). Plotting the parental target height on the growth curve can allow the physi- cian to visualize if the child is growing along a curve consistent with their ge- netic potential, which is seen in familial short stature (Figure 4). Alternatively, children with constitutional delay will have a normal growth velocity, on aver- age about 5 cm per year in a school-aged child, but will have a delayed bone age and be growing along a curve below their parental target height until they achieve their pubertal growth spurt (Figure ...

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... After ruling out endocrine causes for short stature, the same study found that the proportion of CD increased to 19-59%. When using a growth chart, pediatric patients with CD typically demonstrate a decline in both weight and stature velocity, crossing several percentile lines in both categories [27]. In addition, Ludvigsson et al. [28] found that patients with CD are at increased risk of subsequent hip fracture and fracture of any kind, independent of age or sex. ...
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