Short stature resident survival guide: Difference between revisions
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==Overview== | ==Overview== | ||
Short stature is caused by multiple causes such as [[Systemic]] [[disorders]] with secondary effects on growth and [[Pathological|pathologic]] [[short stature]] whish is [[Endocrine]], [[Genetic diseases|Genetic]], and [[Skeletal dysplasia]]<nowiki/>s/[[growth plate]] abnormalities. The incidence of | [[Short stature]] is caused by multiple causes such as [[Systemic]] [[disorders]] with secondary effects on [[growth]] and [[Pathological|pathologic]] [[short stature]] whish is [[Endocrine]], [[Genetic diseases|Genetic]], and [[Skeletal dysplasia]]<nowiki/>s/[[growth plate]] abnormalities. The incidence of [[short stature]] is in the late preterm group was 2.9% which was significantly higher than that in the term group (1.4%). The main symptom of [[short stature]] in children is very short compared to other children of the same age and sex so usually the children with [[short stature]] grow slowly, get their adult [[teeth]] later than normal and have normal proportions (their [[arm]]<nowiki/>s and [[leg]]<nowiki/>s match their height).To diagnose [[short stature]] we have to do the clinic evaluation to know if its identified as a [[short stature]] with dismorphic features or no as well as if the body disproportion or [[Bone age|skeletal]] deformities. Then we can treat the [[short stature]] case by the [[Causes|cause]] of it individually. | ||
==Causes== | ==Causes== | ||
===Common Causes=== | ===Common Causes=== | ||
=== Idiopathic<ref name="pmidPMID 16818584">{{cite journal| author=Allen DB| title=Growth hormone therapy for short stature: is the benefit worth the burden? | journal=Pediatrics | year= 2006 | volume= 118 | issue= 1 | pages= 343-8 | pmid=PMID 16818584 | doi=10.1542/peds.2006-0329 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16818584 }}</ref> === | |||
===[[Systemic]] [[disorders]] with secondary effects on growth<ref name="pmid20605163">{{cite journal| author=Biederman J, Spencer TJ, Monuteaux MC, Faraone SV| title=A naturalistic 10-year prospective study of height and weight in children with attention-deficit hyperactivity disorder grown up: sex and treatment effects. | journal=J Pediatr | year= 2010 | volume= 157 | issue= 4 | pages= 635-40, 640.e1 | pmid=20605163 | doi=10.1016/j.jpeds.2010.04.025 | pmc=2943875 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20605163 }}</ref><ref name="pmid176674802">{{cite journal| author=Swanson JM, Elliott GR, Greenhill LL, Wigal T, Arnold LE, Vitiello B | display-authors=etal| title=Effects of stimulant medication on growth rates across 3 years in the MTA follow-up. | journal=J Am Acad Child Adolesc Psychiatry | year= 2007 | volume= 46 | issue= 8 | pages= 1015-1027 | pmid=17667480 | doi=10.1097/chi.0b013e3180686d7e | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17667480 }}</ref><ref name="pmid18580502">{{cite journal| author=Faraone SV, Biederman J, Morley CP, Spencer TJ| title=Effect of stimulants on height and weight: a review of the literature. | journal=J Am Acad Child Adolesc Psychiatry | year= 2008 | volume= 47 | issue= 9 | pages= 994-1009 | pmid=18580502 | doi=10.1097/CHI.ObO13e31817eOea7 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18580502 }}</ref>:=== | ===[[Systemic]] [[disorders]] with secondary effects on growth<ref name="pmid20605163">{{cite journal| author=Biederman J, Spencer TJ, Monuteaux MC, Faraone SV| title=A naturalistic 10-year prospective study of height and weight in children with attention-deficit hyperactivity disorder grown up: sex and treatment effects. | journal=J Pediatr | year= 2010 | volume= 157 | issue= 4 | pages= 635-40, 640.e1 | pmid=20605163 | doi=10.1016/j.jpeds.2010.04.025 | pmc=2943875 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20605163 }}</ref><ref name="pmid176674802">{{cite journal| author=Swanson JM, Elliott GR, Greenhill LL, Wigal T, Arnold LE, Vitiello B | display-authors=etal| title=Effects of stimulant medication on growth rates across 3 years in the MTA follow-up. | journal=J Am Acad Child Adolesc Psychiatry | year= 2007 | volume= 46 | issue= 8 | pages= 1015-1027 | pmid=17667480 | doi=10.1097/chi.0b013e3180686d7e | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17667480 }}</ref><ref name="pmid18580502">{{cite journal| author=Faraone SV, Biederman J, Morley CP, Spencer TJ| title=Effect of stimulants on height and weight: a review of the literature. | journal=J Am Acad Child Adolesc Psychiatry | year= 2008 | volume= 47 | issue= 9 | pages= 994-1009 | pmid=18580502 | doi=10.1097/CHI.ObO13e31817eOea7 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18580502 }}</ref>:=== | ||
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*[[Growth hormone deficiency]]<ref name="pmid75381452">{{cite journal| author=Rosenfeld RG, Albertsson-Wikland K, Cassorla F, Frasier SD, Hasegawa Y, Hintz RL | display-authors=etal| title=Diagnostic controversy: the diagnosis of childhood growth hormone deficiency revisited. | journal=J Clin Endocrinol Metab | year= 1995 | volume= 80 | issue= 5 | pages= 1532-40 | pmid=7538145 | doi=10.1210/jcem.80.5.7538145 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7538145 }}</ref> | *[[Growth hormone deficiency]]<ref name="pmid75381452">{{cite journal| author=Rosenfeld RG, Albertsson-Wikland K, Cassorla F, Frasier SD, Hasegawa Y, Hintz RL | display-authors=etal| title=Diagnostic controversy: the diagnosis of childhood growth hormone deficiency revisited. | journal=J Clin Endocrinol Metab | year= 1995 | volume= 80 | issue= 5 | pages= 1532-40 | pmid=7538145 | doi=10.1210/jcem.80.5.7538145 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7538145 }}</ref> | ||
[[Genetic diseases]] with primary effects on growth<ref name="pmid2205623">{{cite journal| author=Kaplan SL, Grumbach MM| title=Clinical review 14: Pathophysiology and treatment of sexual precocity. | journal=J Clin Endocrinol Metab | year= 1990 | volume= 71 | issue= 4 | pages= 785-9 | pmid=2205623 | doi=10.1210/jcem-71-4-785 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2205623 }}</ref> | [[Genetic diseases]] with primary effects on growth<ref name="pmidPMID: 15925047">{{cite journal| author=Sheiner E, Levy A, Katz M, Mazor M| title=Short stature--an independent risk factor for Cesarean delivery. | journal=Eur J Obstet Gynecol Reprod Biol | year= 2005 | volume= 120 | issue= 2 | pages= 175-8 | pmid=PMID: 15925047 | doi=10.1016/j.ejogrb.2004.09.013 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15925047 }}</ref><ref name="pmid2205623">{{cite journal| author=Kaplan SL, Grumbach MM| title=Clinical review 14: Pathophysiology and treatment of sexual precocity. | journal=J Clin Endocrinol Metab | year= 1990 | volume= 71 | issue= 4 | pages= 785-9 | pmid=2205623 | doi=10.1210/jcem-71-4-785 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2205623 }}</ref> | ||
*[[Turner syndrome]] | *[[Turner syndrome]] | ||
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==Do's== | ==Do's== | ||
* | *Management decisions often evolve from [[primary care physician]]<nowiki/>s’ threshold for specialist consultation to rule out [[Pathological|pathologic]] causes of shortness, [[pediatric endocrinologist]]<nowiki/>s’ perspective about use of growth-promoting medications, insurance,13–16 and parents concerned that their child is “noticeably shorter than the other kids” or “teased because of his/her size.”<ref name="pmidPMID: 19543124">{{cite journal| author=Cuttler L, Marinova D, Mercer MB, Connors A, Meehan R, Silvers JB| title=Patient, physician, and consumer drivers: referrals for short stature and access to specialty drugs. | journal=Med Care | year= 2009 | volume= 47 | issue= 8 | pages= 858-65 | pmid=PMID: 19543124 | doi=10.1097/MLR.0b013e31819e1f04 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19543124 }}</ref><ref name="pmidPMID: 8709401">{{cite journal| author=Cuttler L, Silvers JB, Singh J, Marrero U, Finkelstein B, Tannin G | display-authors=etal| title=Short stature and growth hormone therapy. A national study of physician recommendation patterns. | journal=JAMA | year= 1996 | volume= 276 | issue= 7 | pages= 531-7 | pmid=PMID: 8709401 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8709401 }}</ref><ref name="pmidPMID: 20805144">{{cite journal| author=Silvers JB, Marinova D, Mercer MB, Connors A, Cuttler L| title=A national study of physician recommendations to initiate and discontinue growth hormone for short stature. | journal=Pediatrics | year= 2010 | volume= 126 | issue= 3 | pages= 468-76 | pmid=PMID: 20805144 | doi=10.1542/peds.2009-3609 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20805144 }}</ref><ref name="pmidPMID: 20427500">{{cite journal| author=Cuttler L, Silvers JB| title=Growth hormone and health policy. | journal=J Clin Endocrinol Metab | year= 2010 | volume= 95 | issue= 7 | pages= 3149-53 | pmid=PMID: 20427500 | doi=10.1210/jc.2009-2688 | pmc=2928896 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20427500 }}</ref> | ||
*Discouraging the reliance on tests that provoke [[GH]] secretions as the only criterion for diagnosing GHD<ref name="urlClinical and Ethical Issues In Managing Idiopathic Short Stature Addressed in New Guidelines">{{cite web |url=https://www.endocrineweb.com/professional/growth-hormone/best-approaches-manage-idiopathic-short-stature-addressed-new-guidelines |title=Clinical and Ethical Issues In Managing Idiopathic Short Stature Addressed in New Guidelines |format= |work= |accessdate=}}</ref> | |||
==Don'ts== | ==Don'ts== |
Latest revision as of 15:55, 9 March 2021
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Eman Alademi, M.D.[2]
Overview
Short stature is caused by multiple causes such as Systemic disorders with secondary effects on growth and pathologic short stature whish is Endocrine, Genetic, and Skeletal dysplasias/growth plate abnormalities. The incidence of short stature is in the late preterm group was 2.9% which was significantly higher than that in the term group (1.4%). The main symptom of short stature in children is very short compared to other children of the same age and sex so usually the children with short stature grow slowly, get their adult teeth later than normal and have normal proportions (their arms and legs match their height).To diagnose short stature we have to do the clinic evaluation to know if its identified as a short stature with dismorphic features or no as well as if the body disproportion or skeletal deformities. Then we can treat the short stature case by the cause of it individually.
Causes
Common Causes
Idiopathic[1]
Systemic disorders with secondary effects on growth[2][3][4]:
- Undernutrition [5]
- Gastrointestinal disease[12][13][14][15]
- Immunologic disease[24]
pathologic short stature[28][29][30][31][32][33][34][35]
Endocrine causes[36] of growth failure
Genetic diseases with primary effects on growth[44][45]
Skeletal dysplasias/growth plate abnormalities[73][74][75][76][77][78]
Diagnosis
Measure your child's height and weight and plot it on growth charts[79], Take x-rays of the bones of your child's hand to measure the bone age, To find out what is causing your child's short stature, doctors may do:,CT scan or MRI of the head,Blood tests.
Doctors do CT or MRI of the head to look for tumors or other problems with the gland that makes growth hormone (the pituitary gland).
Shown below is an algorithm summarizing the diagnosis of according the the Netherlands, guidelines.for referral are based on screening parameters of height SDS, height SDS relative to target height SDS, and height SDS deflection[80][81][82][83][84][85]
Diagnosis and Referral for Non-GH Deficiency Disorders[86]
1.Turner syndrome[87][88][89][90]
2.short-stature homeobox (SHOX) gene insufficiency[91]
3. Noonan syndrome[92]
4.Skeletal disproportions[93]
Gaps in the Diagnosis of Short Stature Due to GH Deficiency: depend on clinical and phenotype assessments with growth monitoring and laboratory evaluations
1. tumors and identify ectopic and hypoplastic pituitary glands[94][95]
2.hypothyroidism and chronic systemic diseases[96][97][98]
Diagnosis | |||||||||||||||||
Treatment
Shown below is an algorithm summarizing the treatment of [[disease name]] according the the [...] guidelines.[99]
1.Normal variants of growth[edit | edit source]
Familial short stature=None needed. Reassurance; monitor growth
Constitutional delay of growth and puberty=None needed. Reassurance; monitor growth; +/– treatment with sex steroids during puberty.
SGA infant, with catch-up growth=Monitor growth to distinguish from the 10% of SGA infants who do not have catch-up growth.
2.Pathologic causes of growth failure[edit | edit source]
Systemic disorders or processes with secondary effects on growth=
Undernutrition=Reverse nutritional deficit.
Glucocorticoid therapy=Minimize glucocorticoid dose or give on alternate days if feasible; consider alternate drugs.
GI disease (especially Crohn disease and celiac disease)=Diagnose and treat underlying disease, improve nutrition, avoid glucocorticoids.
Rheumatologic disease (especially systemic onset juvenile idiopathic arthritis)=Diagnose and treat underlying disease, improve nutrition, avoid glucocorticoids
Renal disease (CKD, renal tubular acidosis)=Diagnose and treat underlying disease, maximize nutrition; GH if needed.
Cancer=Ensure adequate nutrition; treat any secondary pituitary hormone deficiencies (eg, GH deficiency)
Pulmonary disease (eg, cystic fibrosis, immune deficiencies with recurrent pulmonary infections, or severe asthma)=Diagnose and treat underlying disease, ensure adequate nutrition, avoid glucocorticoids
Immunologic disease=Diagnose and treat underlying disease
Endocrine causes of growth failure
Hypothyroidism=Thyroid hormone replacement
Cushing syndrome=Diagnose and treat underlying disease
GH deficiency=rGH
Precocious puberty=Treatment depends on type of precocious puberty
Genetic diseases with primary effects on growth
Turner syndrome=Estrogen, GH
SHOX mutations=Consider GH.
Noonan syndrome=Consider GH.
Silver-Russell syndrome=Consider GH
Skeletal dysplasias
Achondroplasia=Management of complications, which may include craniocervical junction compression, sleep apnea, spinal stenosis.
Hypochondroplasia=Surveillance for spinal stenosis, with surgery as needed.
Spondyloepiphyseal dysplasia=Surveillance for spinal disorders and osteoarthritis, with surgery as needed
Osteogenesis imperfecta=Bisphosphonates, fracture management
Treatment | |||||||||||||||||||||||||||||||||
Do's
- Management decisions often evolve from primary care physicians’ threshold for specialist consultation to rule out pathologic causes of shortness, pediatric endocrinologists’ perspective about use of growth-promoting medications, insurance,13–16 and parents concerned that their child is “noticeably shorter than the other kids” or “teased because of his/her size.”[100][101][102][103]
- Discouraging the reliance on tests that provoke GH secretions as the only criterion for diagnosing GHD[104]
Don'ts
- The content in this section is in bullet points.
References
- ↑ Allen DB (2006). "Growth hormone therapy for short stature: is the benefit worth the burden?". Pediatrics. 118 (1): 343–8. doi:10.1542/peds.2006-0329. PMID 16818584 PMID 16818584 Check
|pmid=
value (help). - ↑ Biederman J, Spencer TJ, Monuteaux MC, Faraone SV (2010). "A naturalistic 10-year prospective study of height and weight in children with attention-deficit hyperactivity disorder grown up: sex and treatment effects". J Pediatr. 157 (4): 635–40, 640.e1. doi:10.1016/j.jpeds.2010.04.025. PMC 2943875. PMID 20605163.
- ↑ Swanson JM, Elliott GR, Greenhill LL, Wigal T, Arnold LE, Vitiello B; et al. (2007). "Effects of stimulant medication on growth rates across 3 years in the MTA follow-up". J Am Acad Child Adolesc Psychiatry. 46 (8): 1015–1027. doi:10.1097/chi.0b013e3180686d7e. PMID 17667480.
- ↑ Faraone SV, Biederman J, Morley CP, Spencer TJ (2008). "Effect of stimulants on height and weight: a review of the literature". J Am Acad Child Adolesc Psychiatry. 47 (9): 994–1009. doi:10.1097/CHI.ObO13e31817eOea7. PMID 18580502.
- ↑ Lifshitz F, Moses N (1988). "Nutritional dwarfing: growth, dieting, and fear of obesity". J Am Coll Nutr. 7 (5): 367–76. doi:10.1080/07315724.1988.10720254. PMID 3053861.
- ↑ Lai HC, FitzSimmons SC, Allen DB, Kosorok MR, Rosenstein BJ, Campbell PW; et al. (2000). "Risk of persistent growth impairment after alternate-day prednisone treatment in children with cystic fibrosis". N Engl J Med. 342 (12): 851–9. doi:10.1056/NEJM200003233421204. PMID 10727589.
- ↑ Doull IJ, Freezer NJ, Holgate ST (1995). "Growth of prepubertal children with mild asthma treated with inhaled beclomethasone dipropionate". Am J Respir Crit Care Med. 151 (6): 1715–9. doi:10.1164/ajrccm.151.6.7767512. PMID 7767512.
- ↑ Wolthers OD, Pedersen S (1991). "Growth of asthmatic children during treatment with budesonide: a double blind trial". BMJ. 303 (6795): 163–5. doi:10.1136/bmj.303.6795.163. PMC 1670402. PMID 1878641.
- ↑ Punthakee Z, Legault L, Polychronakos C (2003). "Prednisolone in the treatment of adrenal insufficiency: a re-evaluation of relative potency". J Pediatr. 143 (3): 402–5. doi:10.1067/S0022-3476(03)00294-4. PMID 14517528.
- ↑ Allen DB, Julius JR, Breen TJ, Attie KM (1998). "Treatment of glucocorticoid-induced growth suppression with growth hormone. National Cooperative Growth Study". J Clin Endocrinol Metab. 83 (8): 2824–9. doi:10.1210/jcem.83.8.5036. PMID 9709954.
- ↑ Allen DB (1996). "Growth suppression by glucocorticoid therapy". Endocrinol Metab Clin North Am. 25 (3): 699–717. doi:10.1016/s0889-8529(05)70348-0. PMID 8879994.
- ↑ Hernández M, Argente J, Navarro A, Caballo N, Barrios V, Hervás F; et al. (1992). "Growth in malnutrition related to gastrointestinal diseases: coeliac disease". Horm Res. 38 Suppl 1: 79–84. doi:10.1159/000182576. PMID 1284243.
- ↑ Vasseur F, Gower-Rousseau C, Vernier-Massouille G, Dupas JL, Merle V, Merlin B; et al. (2010). "Nutritional status and growth in pediatric Crohn's disease: a population-based study". Am J Gastroenterol. 105 (8): 1893–900. doi:10.1038/ajg.2010.20. PMID 20145606.
- ↑ Sawczenko A, Sandhu BK (2003). "Presenting features of inflammatory bowel disease in Great Britain and Ireland". Arch Dis Child. 88 (11): 995–1000. doi:10.1136/adc.88.11.995. PMC 1719349. PMID 14612366.
- ↑ Sanderson IR (2014). "Growth problems in children with IBD". Nat Rev Gastroenterol Hepatol. 11 (10): 601–10. doi:10.1038/nrgastro.2014.102. PMID 24957008.
- ↑ Bechtold S, Roth J (2009). "Natural history of growth and body composition in juvenile idiopathic arthritis". Horm Res. 72 Suppl 1: 13–9. doi:10.1159/000229758. PMID 19940490.
- ↑ Polito C, Strano CG, Olivieri AN, Alessio M, Iammarrone CS, Todisco N; et al. (1997). "Growth retardation in non-steroid treated juvenile rheumatoid arthritis". Scand J Rheumatol. 26 (2): 99–103. doi:10.3109/03009749709115826. PMID 9137323.
- ↑ de Zegher F, Reynaert N, De Somer L, Wouters C, Roelants M (2018). "Growth Failure in Children with Systemic Juvenile Idiopathic Arthritis and Prolonged Inflammation despite Treatment with Biologicals: Late Normalization of Height by Combined Hormonal Therapies". Horm Res Paediatr. 90 (5): 337–343. doi:10.1159/000489778. PMID 29940586.
- ↑ McSherry E, Morris RC (1978). "Attainment and maintenance of normal stature with alkali therapy in infants and children with classic renal tubular acidosis". J Clin Invest. 61 (2): 509–27. doi:10.1172/JCI108962. PMC 372562. PMID 621287.
- ↑ Nandagopal R, Laverdière C, Mulrooney D, Hudson MM, Meacham L (2008). "Endocrine late effects of childhood cancer therapy: a report from the Children's Oncology Group". Horm Res. 69 (2): 65–74. doi:10.1159/000111809. PMID 18059086.
- ↑ Clayton PE, Shalet SM, Morris-Jones PH, Price DA (1988). "Growth in children treated for acute lymphoblastic leukaemia". Lancet. 1 (8583): 460–2. doi:10.1016/s0140-6736(88)91246-9. PMID 2893877.
- ↑ Karlberg J, Kjellmer I, Kristiansson B (1991). "Linear growth in children with cystic fibrosis. I. Birth to 8 years of age". Acta Paediatr Scand. 80 (5): 508–14. doi:10.1111/j.1651-2227.1991.tb11894.x. PMID 1872173.
- ↑ Thommessen M, Heiberg A, Kase BF (1992). "Feeding problems in children with congenital heart disease: the impact on energy intake and growth outcome". Eur J Clin Nutr. 46 (7): 457–64. PMID 1623850.
- ↑ McKinney RE, Robertson JW (1993). "Effect of human immunodeficiency virus infection on the growth of young children. Duke Pediatric AIDS Clinical Trials Unit". J Pediatr. 123 (4): 579–82. doi:10.1016/s0022-3476(05)80955-2. PMID 8410511.
- ↑ Bonfig W, Kapellen T, Dost A, Fritsch M, Rohrer T, Wolf J; et al. (2012). "Growth in children and adolescents with type 1 diabetes". J Pediatr. 160 (6): 900–3.e2. doi:10.1016/j.jpeds.2011.12.007. PMID 22244464.
- ↑ Mauras N, Merimee T, Rogol AD (1991). "Function of the growth hormone-insulin-like growth factor I axis in the profoundly growth-retarded diabetic child: evidence for defective target organ responsiveness in the Mauriac syndrome". Metabolism. 40 (10): 1106–11. doi:10.1016/0026-0495(91)90138-m. PMID 1719338.
- ↑ Clarke WL, Vance ML, Rogol AD (1993). "Growth and the child with diabetes mellitus". Diabetes Care. 16 Suppl 3: 101–6. doi:10.2337/diacare.16.3.101. PMID 8299467.
- ↑ Freire BL, Homma TK, Funari MFA, Lerario AM, Vasques GA, Malaquias AC; et al. (2019). "Multigene Sequencing Analysis of Children Born Small for Gestational Age With Isolated Short Stature". J Clin Endocrinol Metab. 104 (6): 2023–2030. doi:10.1210/jc.2018-01971. PMID 30602027.
- ↑ Wood AR, Esko T, Yang J, Vedantam S, Pers TH, Gustafsson S; et al. (2014). "Defining the role of common variation in the genomic and biological architecture of adult human height". Nat Genet. 46 (11): 1173–86. doi:10.1038/ng.3097. PMC 4250049. PMID 25282103.
- ↑ Hauer NN, Popp B, Schoeller E, Schuhmann S, Heath KE, Hisado-Oliva A; et al. (2018). "Clinical relevance of systematic phenotyping and exome sequencing in patients with short stature". Genet Med. 20 (6): 630–638. doi:10.1038/gim.2017.159. PMC 5993671. PMID 29758562.
- ↑ Ouni M, Castell AL, Rothenbuhler A, Linglart A, Bougnères P (2016). "Higher methylation of the IGF1 P2 promoter is associated with idiopathic short stature". Clin Endocrinol (Oxf). 84 (2): 216–221. doi:10.1111/cen.12867. PMID 26218795.
- ↑ Cuttler L, Marinova D, Mercer MB, Connors A, Meehan R, Silvers JB (2009). "Patient, physician, and consumer drivers: referrals for short stature and access to specialty drugs". Med Care. 47 (8): 858–65. doi:10.1097/MLR.0b013e31819e1f04. PMID 19543124.
- ↑ Cohen P, Rogol AD, Deal CL, Saenger P, Reiter EO, Ross JL; et al. (2008). "Consensus statement on the diagnosis and treatment of children with idiopathic short stature: a summary of the Growth Hormone Research Society, the Lawson Wilkins Pediatric Endocrine Society, and the European Society for Paediatric Endocrinology Workshop". J Clin Endocrinol Metab. 93 (11): 4210–7. doi:10.1210/jc.2008-0509. PMID 18782877.
- ↑ Wit JM, Clayton PE, Rogol AD, Savage MO, Saenger PH, Cohen P (2008). "Idiopathic short stature: definition, epidemiology, and diagnostic evaluation". Growth Horm IGF Res. 18 (2): 89–110. doi:10.1016/j.ghir.2007.11.004. PMID 18182313.
- ↑ Wit JM, Clayton PE, Rogol AD, Savage MO, Saenger PH, Cohen P (2008). "Idiopathic short stature: definition, epidemiology, and diagnostic evaluation". Growth Horm IGF Res. 18 (2): 89–110. doi:10.1016/j.ghir.2007.11.004. PMID 18182313.
- ↑ Rosenfeld RG, Albertsson-Wikland K, Cassorla F, Frasier SD, Hasegawa Y, Hintz RL; et al. (1995). "Diagnostic controversy: the diagnosis of childhood growth hormone deficiency revisited". J Clin Endocrinol Metab. 80 (5): 1532–40. doi:10.1210/jcem.80.5.7538145. PMID 7538145.
- ↑ Magiakou MA, Mastorakos G, Oldfield EH, Gomez MT, Doppman JL, Cutler GB; et al. (1994). "Cushing's syndrome in children and adolescents. Presentation, diagnosis, and therapy". N Engl J Med. 331 (10): 629–36. doi:10.1056/NEJM199409083311002. PMID 8052272.
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value (help). - ↑ Growth Hormone Research Society (2000). "Consensus guidelines for the diagnosis and treatment of growth hormone (GH) deficiency in childhood and adolescence: summary statement of the GH Research Society. GH Research Society". J Clin Endocrinol Metab. 85 (11): 3990–3. doi:10.1210/jcem.85.11.6984. PMID 11095419 PMID: 11095419 Check
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