Make the Dx: Solution to 'A vertically challenged presentation'
Key Takeaways
Can you make the diagnosis? Click here to review the case and check your answer below.
If you’re a pediatrician, you’ll immediately recognize this as a case of idiopathic short stature. Idiopathic short stature is due to familial factors, constitutional growth delay, or both.
This condition is defined as height more than two standard deviations below the mean height per age, sex, and population. About 80% of kids who see a physician for short stature are given a diagnosis with this condition.
Growth hormone treatment in those with idiopathic short stature works, and can add about 3 inches in height during 5 to 6 years of treatment.
It’s important to note, however, that the total financial cost is steep and not readily covered by insurance—about $300,000.
Furthermore, the adverse effects of growth hormone therapy are not well understood, but it is known to increase the risk of diabetes.
More children are getting growth-hormone treatments, and the demand is high—especially among more affluent parents who, some argue, have glommed to designer height as a new status symbol.
It could take years before all the effects of growth hormone in adolescents are elucidated. Thus, all practicing physicians should be familiar with this controversial treatment.
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