MANAGEMENT OF ENDOCRINE DISEASE: Diagnostic and therapeutic approach of tall stature

Eur J Endocrinol. 2017 Jun;176(6):R339-R353. doi: 10.1530/EJE-16-1054. Epub 2017 Mar 8.

Abstract

Tall stature is defined as a height of more than 2 standard deviations (s.d.) above average for same sex and age. Tall individuals are usually referred to endocrinologists so that hormonal disorders leading to abnormal growth are excluded. However, the majority of these patients have familial tall stature or constitutional advance of growth (generally associated with obesity), both of which are diagnoses of exclusion. It is necessary to have familiarity with a large number of rarer overgrowth syndromes, especially because some of them may have severe complications such as aortic aneurysm, thromboembolism and tumor predisposition and demand-specific follow-up approaches. Additionally, endocrine disorders associated with tall stature have specific treatments and for this reason their recognition is mandatory. With this review, we intend to provide an up-to-date summary of the genetic conditions associated with overgrowth to emphasize a practical diagnostic approach of patients with tall stature and to discuss the limitations of current growth interruption treatment options.

Publication types

  • Review

MeSH terms

  • Acromegaly / diagnosis
  • Acromegaly / metabolism
  • Acromegaly / therapy
  • Beckwith-Wiedemann Syndrome / complications
  • Beckwith-Wiedemann Syndrome / diagnosis
  • Body Height*
  • Chromosomes, Human, X / genetics
  • Disease Management
  • Fragile X Syndrome / complications
  • Growth Disorders / diagnosis*
  • Growth Disorders / etiology
  • Growth Disorders / genetics
  • Growth Disorders / therapy
  • Growth Plate / surgery
  • Homocystinuria / complications
  • Homocystinuria / diagnosis
  • Homocystinuria / genetics
  • Humans
  • Insulin-Like Growth Factor I / metabolism
  • Klinefelter Syndrome / diagnosis
  • Klinefelter Syndrome / genetics
  • Marfan Syndrome / diagnosis
  • Marfan Syndrome / genetics
  • Obesity / complications
  • Sex Chromosome Aberrations
  • Sex Chromosome Disorders of Sex Development / diagnosis
  • Sex Chromosome Disorders of Sex Development / genetics
  • Sotos Syndrome / complications
  • Sotos Syndrome / diagnosis
  • Sotos Syndrome / genetics
  • Thyrotoxicosis / complications
  • Trisomy / diagnosis
  • Trisomy / genetics

Substances

  • Insulin-Like Growth Factor I

Supplementary concepts

  • Growth hormone excess
  • Triple X syndrome