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Review
. 2013 Mar 28;368(13):1220-8.
doi: 10.1056/NEJMcp1213178.

Clinical practice. Short stature in childhood--challenges and choices

David B Allen  1 , Leona Cuttler
Affiliations
Review

Clinical practice. Short stature in childhood--challenges and choices

David B Allen et al. N Engl J Med. .
No abstract available

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Conflict of interest statement

Disclosure:

No other potential conflict of interest relevant to this article was reported. Disclosure forms provided by the authors are available with the full text of this article at NEJM.org.

Figures

Figure 1
Figure 1
Growth curve and clinical data of the patient. Predicted adult height (PAH) for observation-alone approach calculated using Bayley-Pinneau method.
Figure 2
Figure 2
Conceptual approach to the evaluation and differential diagnosis of worrisome growth and short stature. (adapted from) Key: * = downward crossing of percentiles, height < 3rd percentile, or height inappropriate for family, or abnormal body proportions; %tile = growth curve percentile; GV = growth velocity; BA = bone age; CA = chronological age; TS = Turner syndrome; RSS = Russell Silver syndrome; IUGR = intrauterine growth restriction; CDGP = constitutional delay in growth and puberty; GHD = growth hormone deficiency; CS = Cushing syndrome; CRI = chronic renal insufficiency; IBD = inflammatory bowel disease
Figure 3
Figure 3
Illustration of approximate projections (± 1.3 inches based on Bayley Pinneau adult height predictions at 11 years of age with bone age of 9) for growth trajectory and adult height for various short stature treatments based on published reports of their effects * = assuming increase in growth rate to ~8 cm/year until onset of puberty ** = assuming average reported increment in height gain for ISS + ~1 cm/year of treatment., *** = assuming normal pubertal growth after cessation of hGH at onset of puberty (and thus no significant difference from more prolonged standard dose hGH therapy). **** =assuming additional increment of 3.6 cm of height (compared to standard-dose hGH therapy) due to 3 years of high-dose (0.7mg/kg/wk) hGH.
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