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- How to differentiate between familial short stature and constitutional delay in
growth and puberty?
FSS and CDGP are normal variants of short stature and are associated with a
strong family history. Children with both these disorders are born with a normal
birth length; however, during infancy they cross the centile curves downward so
that the height falls <3rd percentile by the end of second or third year of life
(“catch down” growth). Subsequently, these children have normal height veloc-
ity till puberty. Children with FSS have normal onset of puberty and eventually
have short final adult height (although within their target height range), whereas
children with CDGP have a delay in the onset of puberty but eventually attain
normal final adult height. GH–IGF1 dynamics are essentially normal in both
these variants, except in a few children with CDGP where integrated GH secre-
tion has been shown to be abnormal (low GH pulse frequency and amplitude).
a bFig. 1.14 (a) A 12-year-old girl with familial short stature along with her father (who is also
short). (b) X-ray wrist AP view showing bone age of 12 years
1 Disorders of Growth and Development: Clinical Perspectives