In our country, short stature in childhood and during adolescence is a concern not just for the children but also their parents. Multiple factors determine the final adult height of an individual from fetal period until the final adult height is achieved. While nutrition and genetics are the major determinants of growth and stature, any systemic illness for a considerable duration will have influence on the height of the child. A handful of endocrine conditions need to be ruled out in those with significant short stature without evidence of chronic illnesses.
Amongst them are hypothyroidism, growth hormone deficiency, vitamin D deficiency, rickets, Cushings syndrome. In addition, all females with short stature should be evaluated for Turner syndrome, a chromosomal disorder. Hypothyroid and vitamin D deficient kids require treatment with thyroxine and vitamin D respectively. In Cushings syndrome the source of excess cortisol in the body needs to be localized and surgically removed.
In children with growth hormone deficiency and Turner syndrome, early treatment with recombinant growth hormone improves outcome. Growth hormone therapy for improving final adult height is also accepted in children with chronic kidney disease and in those who were small at birth or had a low birth weight. Idiopathic short stature (ISS) is the term used for children who are short but on investigating for short stature found to have no underlying cause. In such patients, a trial of growth hormone may be given.
