Short Stature: Causes, Types and Treatments

little girl measuring herself

The term “short stature” may be used in a variety of ways and generally means a person’s height is below average.  In children, height is measured from birth to track normal growth patterns based on the individual’s circumstance. While a child’s growth may be significantly slower than normal, they may be perfectly healthy.  However, short stature may signify an underlying medical condition.   

Common Attributes & Causes

boy growing himself with watering can

When a child’s growth is significantly slower than normal, there are typically three reasons; genetics (familial), constitutional delay, or a chronic disease.  

Genetics/ Familial Short Stature

When children have familial short stature it will be evident in their genetic makeup.  They will typically have short parents and grandparents. In these cases, the children grow at a normal rate and they will enter puberty at a normal age.  Their growth is consistent with their genes and there is no underlying medical reason to be concerned about. There are, however, genetic diseases that are not familial in nature that can lead to short stature.  These conditions are addressed below.  

Constitutional Delay in Growth and Puberty

Constitutional growth delay can be easily described as children who are “late bloomers.”  In this situation, the child’s growth rate may be within a normal range but they are simply small for their age.  

Typically, children who have a constitutional growth delay also have a close relative who showed similar growth delay patterns.  “Late bloomers” may also enter puberty at an older age. Thus, even though their peers may grow faster, these children will continue to grow when others have stopped.  In fact they may not, especially in males, reach their full adult height until after the age of 18.   

There are, however, a few situations that may cause constitutional growth delay including malnutrition and psychosocial stress.  These situations can be reversed with proper nutrition and by removing the child from unhealthy, stressful situations.  

Short Stature from an Underlying Condition

There are many diseases that can cause short stature in children.  While some diseases display obvious results, others are much more subtle and leave parents perplexed and anxious.  Dr. Joshua Smith, who is a pediatric endocrine specialist, can help identify conditions and provide treatment plans. 

Types of Short Stature Causes by Disease

The following chart outlines some of the diseases that can cause short stature in children.

Endocrine Disease

  • Growth Hormone Deficiency
  • Hypothyroidism
  • Cushing’s Disease
  • Diabetes
  • Tumor in an Endocrine Gland

Chronic Disease

  • Heart Disease
  • Asthma
  • Inflammatory Bowel Disease
  • Kidney Disorders
  • Sickle Cell Anemia
  • Juvenile Idiopathic Arthritis

Genetic Disease

  • Down Syndrome
  • Turner Syndrome
  • Williams Syndrome
  • Prader-Willi Syndrome
  • Noonan Syndrome
  • SHOX Deficiency

Bone/Skeletal Disease

  • Rickets
  • Achondroplasia
  • Hypochondroplasia

Diagnosis and Treatment

Children with familial or constitutional delay short stature are normal if they do not have any symptoms related to diseases that affect growth.  In such cases, parents need not worry as their children will simply grow and enter puberty later than other children.

To diagnose short stature related to disease, Dr. Smith will perform a complete medical history and physical examination that will include measurements of the child’s height, weight, limbs, and trunk.  He may also perform blood tests to determine if the cause of short stature is related to a hormone deficiency or genetic disorder.

Symptoms

Children who show symptoms of disease should contact Dr. Joshua Smith for further evaluation.  These symptoms include:

  • Frequent tiredness, fatigue
  • An elementary aged child that grows slower than two inches in a year
  • An elementary aged child who is significantly shorter than their peers (below the 3rd percentile)
  • An elementary aged child that stops growing (i.e. last year’s clothes fit comfortably)
  • Weight loss of more than five pounds in a month
  • Loss of appetite
  • Delayed puberty:  In girls, absent breast development by age 14 and menstrual spotting by age 15
  • Delayed puberty:  In boys, absent enlargement of the testes by age 14

Treatments

The treatment options for short stature will depend on the cause.  If there are signs of malnutrition, for example, the child may require nutritional supplements or treatment for a bowel disorder.

If it is determined that growth is delayed due to a hormonal problem, growth hormone treatment may be necessary.  If a tumor is identified, surgery may be required. Only after a physical examination and testing will proper treatments be discussed with Dr. Smith.

Dr Josh measuring the height of a young girl.

Pediatric Endocrinology Specialist

If your child is experiencing any of the short stature symptoms described above, call Dr. Joshua Smith for an appointment or fill out the form below.

Dr. Smith is the region’s only specialist in pediatric endocrinology and is specifically trained to properly diagnose and treat short stature.

The prognosis for children with short stature is excellent.  Effective treatments, if necessary, are available but remember, early intervention can prevent future problems in many cases.

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