Study of the profile of children and adolescents with short stature in Pediatric Endocrinology Unit at Tanta University Hospital

Background Growth and development are specific hallmarks of childhood. In most children, they occur spontaneously with no interruption. A complex system controls the initiation, rate, and cessation of growth. Short stature is a condition in which the height of the individual is more than 2 SD below the corresponding mean height for a given age, sex, and population. It may be either a variant of normal growth or caused by certain pathology. Normal variants of short stature may be constitutional, familial, or idiopathic causes, whereas pathological causes may be endocrinal, syndromatic, chronic illness, skeletal dysplasia, or nutritional. Careful evaluation of causes of short stature to exclude normal variants, early diagnosis, and treatment of pathologic causes is important for better prognosis. Growth hormone (GH) is used for treatment of other causes of short stature rather than GH deficiency. Aim The aim of this retrospective study was to study the profile of children with short stature to seek a better way for management and follow-up of these populations. Patients and methods This retrospective study included all children with short stature who were recorded and recruited from Endocrinology Unit at Tanta University Hospital during the period from 2009 to 2015 from age of 1 to 16 years. The profile of cases was reviewed from their medical records including complete history, clinical data (weight, height, BMI, and Z-score for height, and weight), and laboratory investigations (complete blood count, liver and renal functions, cholesterol, triglycerides, high-density lipoprotein, low-density lipoprotein, GH provocation tests, thyroid function tests, insulin growth factor-1 level, and bone age). Results The most common cause of short stature was normal variants (49.1%), mainly constitutional (22.1%) followed by endocrinal (35.3%) causes. The most common endocrinal cause of short stature was hypothyroidism (19%). Short stature is more prevalent in rural areas (67%) than urban areas (33%). The prevalence rate of short stature is more among female (51%) than male (49%) individuals. Treatment with recombinant human GH in cases of GH deficiency was done in a dose of 0.18-0.3 mg/kg/week (77.1%), and the most effective dose was found to be 0.2 mg/kg/week (62.6%), with the best effect on height, height velocity, and final height. Treatment with levothyroxine in cases of hypothyroidism leads to improvement of height velocity. Conclusion The most common cause of shor