Clinical_Rounds_in_Endocrinology_Volume_II_-_Pediatric_Endocrinology

17

Short stature

Dysmorphic features

Present

• Turner’s syndrome


• Down’s syndrome


• Noonan’s syndrome


• Prader-Willi syndrome


• Russell-Silver syndrome


• Pseudohypoparathyroidism
  
  
  • GHD
  
  
  • Cushing’s syndrome
    
    
    • CDGP
    
    
    • FSS
      
      
      • Chronic
        system disease
      
      
      • Malnutrition
        
        
        • Hypothyroidism
        
        
        • Rickets
        
        
        • Achondroplasia
        
        
        • Osteogenesis
          imperfecta
          
          
          • Mucopoly-
            saccharoidosis
          
          
          • Kyphoscoliosis
          
          
          • Spondylo-
            epiphyseal
            dysplasia
          
          
          
          
        
        
        
        
      
      
      
      
    
    
    
    
  
  
  
  

Overweight

for height

Normal weight

for height

Underweight

for height

Proportionate

short stature

Disproportionate

short stature

Short

limbs

Short

trunk

Absent

Fig. 1.8 Approach to a child with short stature

21. What is the importance of measurement of parental height in a child with short
    stature?
    Genetic factors have a significant contribution to the final adult height of an
    individual. Therefore, an estimate of the genetic potential for the final adult
    height of an individual can be predicted on the basis of height of the parents.
    Midparental height (MPH) is a widely used tool to calculate the genetic
    potential of an individual. MPH can be calculated as follows:

Paternalheight Maternalheight for boys

Paternalheight

()++ ̧

+

13 2

()MMaternalheight- 13 ̧ 2 forgirls

22. What is the target height of an individual?

Children of short parents are not as short as their parents, and, similarly, chil-

dren of tall parents are not as tall as their parents due to the phenomenon of

regression to the mean. Therefore, the concept of target height was introduced

to predict the final adult height of an individual with allowance for regression

to the mean. The phenomenon of regression to the mean indicates that an indi-

vidual has a tendency to attain a final adult height which is toward mean adult

height of that particular population (i.e., 50th percentile). However, an individ-

ual can only compensate up to 20 % of the difference between midparental

height and mean adult height of that particular population, e.g., if the MPH of

1 Disorders of Growth and Development: Clinical Perspectives