Short Stature in Children (cont.)

Medical Author:

Robert Ferry Jr., MD

Robert Ferry Jr., MD

Robert Ferry Jr., MD, is a U.S. board-certified Pediatric Endocrinologist. After taking his baccalaureate degree from Yale College, receiving his doctoral degree and residency training in pediatrics at University of Texas Health Science Center at San Antonio (UTHSCSA), he completed fellowship training in pediatric endocrinology at The Children's Hospital of Philadelphia.

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Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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All causes of short stature fall into one of three major categories: chronic disease (for example, malnutrition), familial short stature, or constitutional delay of growth and development ("late bloomers"). Worldwide, malnutrition is the most common cause of growth failure and is usually related to poverty or anarchy. Nutritional deficiencies in developed countries are more often the result of self-restricted diets. Poor weight gain is often more noticeable than short stature.

Children with familial short stature have short parents. These normal children display normal growth velocity (speed of growth over time), and their bone development is normal (as indicated by the bone age corresponding to the calendar age). Children with familial short stature enter puberty at a normal time and typically complete growth with a height consistent with that of their parents.

Constitutional growth delay is a term used to describe normal children who are small for their age but who have a normal growth rate. Constitutional growth delay is characterized by delayed bone age, normal growth velocity, and a predicted adult height appropriate to the family pattern. Children with constitutional growth delay, often called "late bloomers," typically have a close relative who displayed constitutional growth delay. For example, the relative with late blooming may have had her first menstrual period when she was older than 15 years. A male relative with late blooming may have reached his final adult height after age 18 years.

Although rare, endocrine disorders, such as hypothyroidism (thyroid hormone deficiency) or growth hormone deficiency also cause growth failure. Short stature is commonly associated with genetic diseases, such as a SHOX gene mutation, Down syndrome, or Turner syndrome.