Short people are defined statistically as being significantly shorter than their peers. For adult women, this is less than 4 foot 11 inches and men less than 5 feet 4 inches. Children who growth at the lower rates (percentiles) most often come from short families themselves (familial short stature), and/or are destined to undergo their puberty later than average (constitutionally delayed adolescence), and therefore to grow for a longer period than others. The Clinic evaluates short children first in respect to these two possibilities and if adult height predictions based upon the Clinic measurement of height and bone age read from an X-ray of the left hand) fall below expectations based upon the heights of the parents, the children will be worked-up as to possible underlying causes (GH deficiency, celiac disease, renal disease, hypothyroidism, Turner’s syndrome, inflammatory bowel disease etc)
For most short children, no such cause is identifiable. In these children with unexplained or idiopathic short stature (ISS), medications to enhance growth and to prolong the growth period are often undertaken by the Clinic. One FDA approved indication for GH therapy is where children have been born at a smaller size than their gestation age and have not caught up with the growth of their peers by age 2 years. Another indication is that in short children who are destined to become short adults and are growing abnormally slowly. The Clinic will work with the families to obtain GH therapy for these indications through the various insurance agencies, and collaborates with pharmaceutical companies to begin GH therapy pending insurance approvals. The Clinic offers other forms of management besides GH depending upon the clinical situation, and the wishes of the child and family.