Clinical and etiological profile of children with pathological short stature

Abstract

Normal growth is considered to be an indirect indicator of overall wellbeing of the child, any alteration or disturbance in the linear growth is found be one of the most common concerns for the family. A child is considered to be short, when his or her height is below the third centile or < 2 standard deviation on the height chart used for specific population. Approximately 3% children in any population are found to be short, amongst which half of them will be physiological (familial or constitutional) and half will be pathological. 1 Short stature is not a diagnosis but a presenting symptom, sometimes the first clinical manifestation of an underlying pathological disease, like endocrinological disease eg. Growth hormone deficiency (GHD), chronic diseases eg. Chronic renal failure, disesases of bone eg. Skeletal dysplasia or clinically defined syndromes eg. Downs; thus, short stature has to be evaluated precisely. 2 Short stature is a result of various diverse etiologies, which are categorized in two groups broadly as pathological causes and normal variants. Normal variant short stature includes familial short stature (FSS) and constitutional growth delay (CGD), while there are broad ABSTRACT Background: Short stature is one of the common problem in child population with diverse aetiologies, half of them being physiological and another half due to pathological causes. The objective of this study was to study the clinical profile of the children with pathological short stature and to study the various causes for pathological stature Methods: Retrospective study was conducted in the Department of Paediatrics, Chettinad Hospital and Research Institute, where the data of Children who met the inclusion criteria were collected from the case records of 2 years period from Jan 2013 to December 2014. Data collected was tabulated and analyzed using appropriate statistical methods. Results: Commonest age group affected was < 5 years about 48%, 34% were 5-10 years and 17% were > 10 years. 48% were males and 52% were females. Commonest causes were Hypothyroidism and genetic disorders, followed by nutritional and musculoskeletal. 58% were proportionate and 42% were disproportionate. Conclusions: Endocrinological and genetic syndromes are most common etiologies for pathological short stature. So detailed evaluation of short stature is very important as some of the pathological causes are treatable when diagnosed at an early stage.

Etiological profile of short stature in rural Rajasthan

“…This hospital-based study was performed to outline the etiology of short stature and their frequency of occurrence in 2-18-yearold rural pediatric population, where gender discrimination is rampant resulting in a skewed ratio with male predominance. The M: F ratio in other studies varied from 0.9:1 to 1.8:1 [3,[13][14][15][16]. Majority of the affected children were in the age group of 2-<10 years, which may be due to the fact that parents are very worried and curious about the growth of their children during this early childhood period.…”

Etiological Study of Short Stature among Children Attending Outpatient Department of Pediatrics in a Tertiary Care Medical College Hospital

“…[2,[15][16][17][18] The studies done by Lashari et al (.9:1), Ganavi et al (.9:1), had a female predominance in short stature which is contrary to our study. [19,20]. Epidemiologic data indicate that all variants of short stature are twice as common in boys as in girls.…”

“…). [1,14,20,23,17,18,19,27,25] Most of these studies are being done in endocrine clinic of tertiary hospitals where more of endocrinologic causes will be encountered. Endocrine disease was one of the causes of pathological short stature in child and it was found to be high in females than males with 31% and 10% respectively (P<0.01).…”

“…[1,14] Endocrine causes were low in Shiva ) which are conflicting to our study. [15,19,20,[24][25][26] This may be due to the difference of study settings where each study is being done. Hypothyroidism (16%) was the most common endocrine cause of short stature in our study.…”

Clinicoepidemiological Profile of Short Stature at a Tertiary Care Centre in North India

“…In previous studies [8,10], celiac disease has not been reported as a cause. Even in the newer literature from India [7,13,18], it has not even been studied as one of the causes. This might be because these studies come from western and southern India, where the population is predominantly consuming rice and therefore, the overall prevalence of celiac disease itself is not as much as in our population.…”