Journal of Child

SUBMITINFORMATION
EnglishTürkçe

Research Article


DOI :10.5222/j.child.2019.18942   IUP :10.5222/j.child.2019.18942    Full Text (PDF)

Etiologic Evaluation of Severe Short Stature in Children at a Tertiary Pediatric Endocrinology Centre

Utkucan Uçkun, Firdevs Baş, Şükran Poyrazoğlu, Nur Mine Şükür, Fatma Feyza Darendeliler, Rüveyde Bundak

Objective: The aim of this study was to describe the characteristics and the etiological profile of children with severe short stature evaluated at a tertiary Pediatric Endocrinology centre in Istanbul. Method: Randomly selected 500 patients with the diagnosis of severe short stature height SDS<-3SD) were selected for this study. Among those, 320 patients with at least 12 months of follow-up were included. Results: Among these patients pathological short stature was diagnosed in 94.1%. Endocrine disorders (50.9%) was found to be the leading cause among pathological short stature; followed by specific syndromes and chromosomal abnormalities (13.2%), disproportionate short stature (12.8%), chronic diseases and malnutrition (12.8%), small for gestational age (SGA) with failure of catch-up growth (3.8%) and psychosocial short stature (0.6%). Of those with endocrine disorders; the most common etiology was growth hormone deficiency (GHD) (95.2%). Conclusion: Pathological causes should be ruled out in children with severe short stature. Our results showed that the most common cause was GHD among all subjects.

Keywords: : Severe short stature, children, etiology, growth hormone deficincy
DOI :10.5222/j.child.2019.18942   IUP :10.5222/j.child.2019.18942    Full Text (PDF)

Üçüncü Basamak Bir Pediatrik Endokrinoloji Merkezinde İzlenen Ağır Boy Kısalığı Vakalarının Etiyolojik Değerlendirmesi

Utkucan Uçkun, Firdevs Baş, Şükran Poyrazoğlu, Nur Mine Şükür, Fatma Feyza Darendeliler, Rüveyde Bundak

Amaç: Araştırmamızın amacı İstanbul’da üçüncü basamak bir Pediatrik Endokrinoloji merkezinde izlenen ağır boy kısalığı olgularının etiyolojik profilini ve karakteristiklerini incelemektir. Yöntem: Rastgele seçilen 500 ağır boy kısalığı (boy SDS <-3SD) vakasından izlem süresi 12 ay ve üzeri olan 320 hasta çalışmaya alınmıştır. Bulgular: Vakaların %94.1’inde patolojik boy kısalığı saptanmıştır. Patolojik boy kısalıklarında en sık etiyolojik neden endokrin bozukluklar (%50,9) olarak saptanmıştır. Bunu sırasıyla spesifik sendromlar ve kromozom anomalileri (%13,2), orantısız boy kısalıkları (%12,8), kronik hastalıklar ve malnütrisyon (%12,8), catch-up büyümeyi yakalayamayan gebelik yaşına göre küçük (SGA) vakalar (%3,8) ve psikososyal boy kısalığı (%0,6) izlemektedir. Endokrin bozukluklar içinde en sık etiyolojik neden büyüme hormonu eksikliğidir (%95,2). Sonuç: Ağır boy kısalığı olan çocuklarda patolojik boy kısalığı nedenleri dışlanmalıdır. Araştırmamız ağır boy kısalığı olgularında en sık etiyolojik nedenin endokrin bozukluklar olduğunu göstermiştir. Gerek tüm olgularda gerek de endokrin bozukluklar içinde en sık etiyolojik neden büyüme hormonu eksikliği olarak saptanmıştır.

Keywords: Ağır boy kısalığı, çocuklar, etiyoloji, büyüme hormonu eksikliği

PDF View

References

  • 1. Sen Y, Bozdag S. The etiological distribution of patients admitted to the pediatric endocrinology clinic. Fırat University Journals of Health Sciences 2008;22(2): 53-8. google scholar
  • 2. Rosenfield R, Cuttler L. Short stature. In: DeGroot LJ, Jamesan JL, eds. Endocrinology. 4th ed. Philadelphia: WB Saunders, 2001:485-94. google scholar
  • 3. Marcovitch H. Failure to thrive. Br Med J. 1994;308: 35-8. https://doi.org/10.1136/bmj.308.6920.35 google scholar
  • 4. Frindik JP, Kemp SF, Hunold JJ. Near adult heights after growth hormone treatment in patients with idiopathic short stature or idiopathic growth hormone deficiency. J Pediatr Endocrinol Metab 2003;16:607-12. google scholar
  • 5. Vogiatazi MG, Copland KC. The short child. Pediatr Rev 1998;19:92-9. https://doi.org/10.1542/pir.19-3-92 google scholar
  • 6. Thomas Aceto JR, Dempsher D. Short stature and slow growth in the young. In: Becker KL, eds. Principles and Practice of Endocrinology and Metabolism. 3rd ed. Philadelphia: Lippincott Williams and Wilkins, 2001:1784-97. google scholar
  • 7. Rosenfeld RG. Growth retardation. In: Sperling MA, eds. Pediatric Endocrinology. Philadelphia: WB Saunders, 1996:135-57. google scholar
  • 8. Reiter O, Rosenfeld Ron G. Growth retardation. In: Williams RH, Wilson JD, eds. Williams Textbook of Endocrinology. 9th ed. Philadelphia: WB Saunders, 1998:1453-8. google scholar
  • 9. Jan M Wit. International Classification of Pediatric Endocrine Diagnoses. Horm Res Paediatr. 2016;86(3): 212-4. https://doi.org/10.1159/000448893 google scholar
  • 10. American Academy of Pediatrics. Recommendations for Preventive Pediatric Health Care Committee on Practice and Ambulatory Medicine. Pediatrics 2000;105:645-6. https://doi.org/10.1542/peds.105.3.645 google scholar
  • 11. Lacey KA, Parkin JM. Causes of short stature. A community study of children in Newcastle upon Tyne. Lancet 1974;1(7846):42-5. https://doi.org/10.1016/S0140-6736(74)93041-4 google scholar
  • 12. Voss LD. Growth hormone therapy for the short normal child: who needs it and who wants it? The case against growth hormone therapy. J. Pediatr. 2000;136:103-6. https://doi.org/10.1016/S0022-3476(00)90058-1 google scholar
  • 13. Voss LD, Mulligan J, Betts PR, Wilkin TJ. Poor growth in school entrants as an index of organic disease: the Wessex growth study. BMJ 1992;305:1400-2. https://doi.org/10.1136/bmj.305.6866.1400 google scholar
  • 14. Zafer Y, Kandemir N, Yordam N. Etiological distribution of short stature: Evaluation of 1013 cases. Journal of Child Health and Diseases 1999;42:205-13. google scholar
  • 15. Demirel F, Bideci B, Camurdan MO, Arga M, Cinaz P. Etiological causes of short stature in children. Turkish Archives of Pediatrics 2005;40(1):39-43. google scholar
  • 16. Fenton TR, Kim JH. A systematic review and metaanalysis to revise the Fenton growth chart for preterm infants. BMC Pediatr. 2013;13:59. https://doi.org/10.1186/1471-2431-13-59 google scholar
  • 17. Neyzi O, Bundak R, Darendeliler F, Günöz H. Büyüme Gelişme ve Bozuklukları. In: Neyzi O, Ertuğrul T, eds. Pediyatri Cilt 1, 4th ed, Istanbul: Nobel Tıp Kitapevleri, 2010:89-149. google scholar
  • 18. Marshall WA, Tanner JM. Variations in pattern of pubrtal changes in girls. Arch Dis Child. 1969;44:291-303. https://doi.org/10.1136/adc.44.235.291 google scholar
  • 19. Marshall WA, Tanner JM. Variations in pattern of pubrtal changes in boys. Arch Dis Child. 1970;45:13-23. 76 Çocuk Dergisi 2019;19(2):63-76 https://doi.org/10.1136/adc.45.239.13 google scholar
  • 20. Bundak R, Furman A, Gunoz H, Darendeliler F, Bas F, Neyzi O. Body mass index for Turkish children aged 6 to 18 years. Acta Paediatr 2006;95:194-8. https://doi.org/10.1080/08035250500334738 google scholar
  • 21. Neyzi O, Furman A, Bundak R, Gunoz H, Darendeliler F, Bas F. Growth references for Turkish children aged 6 to 18 years. Acta Paediatr. 2006;95:1635-41. https://doi.org/10.1080/08035250600652013 google scholar
  • 22. Neyzi O, Gunoz H, Furman A, Türk çocuklarında vücut ağırlığı, boy uzunluğu, baş çevresi ve vücut kitle indeksi referans değerleri. Çocuk Sağlığı ve Hastalıkları Dergisi 2008;51:1-14. google scholar
  • 23. WHO Multicentre Growth Reference Study Group. WHO Child Growth Standards Acta Paediatrica Supplement 2006;450. google scholar
  • 24. De Onis M, Onyango AW, Borghi E, Siyam A, Nishida C, Siekmann J. Development of a WHO growth reference for school-aged children and adolescents. Bulletin of the World Health Organization, 2007;85(9):649-732. https://doi.org/10.2471/BLT.07.043497 google scholar
  • 25. McLaren DS, Read WWC. Classification of nutritional status in early childhood. Lancet 1972;2(7769):146-8. https://doi.org/10.1016/S0140-6736(72)91324-4 google scholar
  • 26. Tanner JM, Goldstein H, Whitwhouse RH. Standards for children’s height at age 2-9 years allowing for height of parents. Arch Dis Child. 1970;45:755-62. https://doi.org/10.1136/adc.45.244.755 google scholar
  • 27. Bayley N, Pinneau SR. Tables for predicting adult height from skeletal age: revised for use with the GreulichPyle hand standart. J Pediatr. 1952;40:423-41. https://doi.org/10.1016/S0022-3476(52)80205-7 google scholar
  • 28. Şükür M, Baş F, Darendeliler F ve ark. Pediatrik endokrinoloji polikliniğine müracaat eden hastaların etiyolojik dağılımı: pilot çalışma. Pediatrik Endokrinoloji Kongresi Bildiri Özet Kitabı, 14-17 Eylül 2006, Konya, 2006:140. google scholar
  • 29. Lindsay R, Feldkamp M, Harris D, Robertson J, Rallison M. Utah Growth Study: growth standards and the prevalence of growth hormone deficiency. J Pediatr. 1994;125:29-35. https://doi.org/10.1016/S0022-3476(94)70117-2 google scholar
  • 30. Song KC, Jin SL, Kwon AR, Chae HW, Ahn JM, Kim DH, et al. Etiologies and characteristics of children with chief complaint of short stature. Ann Pediatr Endocrinol Metab. 2015;20:34-9. https://doi.org/10.6065/apem.2015.20.1.34 google scholar
  • 31. Strufaldi MWL, da Silva EMK, Puccini RF. Follow-up of children and adolescents with short stature: the importance of the growth rate. Sao Paulo Med J. 2005;123(3):128-33. https://doi.org/10.1590/S1516-31802005000300008 google scholar
  • 32. Shiva S, Nikzad A. Etiology of short stature in East Azerbaijan, Iran. Iran J Pediatr. 2009;19:35-40. google scholar
  • 33. Moayeri H, Aghighi Y. A prospective study of etiology of short stature in 426 short children and adolescents. Arch Iranian Med. 2004;7:23-7. google scholar
  • 34. Lashari SK, Korejo HB, Memon YM. To determine frequency of etiological factors in short statured patients presenting at an endocrine clinic of a tertiary care hospital. Pak J Med Sci. 2014;30:858-61. https://doi.org/10.12669/pjms.304.4619 google scholar
  • 35. Zargar AH, Laway BA, Masoodi SR. An aetiological profile of short stature in the Indian subcontinent. J Pediatr Child Health. 1998;34:571-6. https://doi.org/10.1046/j.1440-1754.1998.00308.x google scholar
  • 36. Papadimitriou A, Douros K, Papadimitriou DT, Kleanthous K, Karapanou O, Fretzayas A. Characteristics of the short children referred to an academic paediatric endocrine clinic in Greece. J Paediatr Child Health. 2012;48:263-7. https://doi.org/10.1111/j.1440-1754.2011.02256.x google scholar
  • 37. Bhadada SK, Bhansali A, Ravikumar P, Kochhar R, Nain CK, Dutta P, et al. Changing scenario in aetiological profile of short stature in India-growing importance of celiac disease: a study from tertiary care centre. Indian J Pediatr. 2011;78(1):41-4. https://doi.org/10.1007/s12098-010-0227-6 google scholar
  • 38. Tunçbilek E, Özgüç M. Application of medical genetics in Turkey. The Turkish Journal of Pediatrics 2007;49: 353-9. google scholar
  • 39. Binder G. Short stature due to SHOX deficiency: Genotype, phenotype, and therapy. Horm Res Paediatr. 2011;75:81-89. https://doi.org/10.1159/000324105 google scholar
  • 40. Saenger P, Czernichow P, Hughes I, Reiter EO. Small for gestational age: Short stature and beyond. Endocr Rev. 2007;28(2):219-51. https://doi.org/10.1210/er.2006-0039 google scholar
  • 41. Chernausek SD. Mendelian genetic causes of the short child born small for gestational age. J Endocrinol Invest. 2006;29(1):16-20. google scholar
  • 42. Jee YH. Genetics of Short Stature. Endocrinol Metab Clin North Am. 2017;46(2):259-81. https://doi.org/10.1016/j.ecl.2017.01.001 google scholar

Citations

Copy and paste a formatted citation or use one of the options to export in your chosen format


EXPORT



APA

Uçkun, U., Baş, F., Poyrazoğlu, Ş., Şükür, N.M., Darendeliler, F.F., & Bundak, R. (2019). Etiologic Evaluation of Severe Short Stature in Children at a Tertiary Pediatric Endocrinology Centre. Journal of Child, 19(2), 63-76. https://doi.org/10.5222/j.child.2019.18942


AMA

Uçkun U, Baş F, Poyrazoğlu Ş, Şükür N M, Darendeliler F F, Bundak R. Etiologic Evaluation of Severe Short Stature in Children at a Tertiary Pediatric Endocrinology Centre. Journal of Child. 2019;19(2):63-76. https://doi.org/10.5222/j.child.2019.18942


ABNT

Uçkun, U.; Baş, F.; Poyrazoğlu, Ş.; Şükür, N.M.; Darendeliler, F.F.; Bundak, R. Etiologic Evaluation of Severe Short Stature in Children at a Tertiary Pediatric Endocrinology Centre. Journal of Child, [Publisher Location], v. 19, n. 2, p. 63-76, 2019.


Chicago: Author-Date Style

Uçkun, Utkucan, and Firdevs Baş and Şükran Poyrazoğlu and Nur Mine Şükür and Fatma Feyza Darendeliler and Rüveyde Bundak. 2019. “Etiologic Evaluation of Severe Short Stature in Children at a Tertiary Pediatric Endocrinology Centre.” Journal of Child 19, no. 2: 63-76. https://doi.org/10.5222/j.child.2019.18942


Chicago: Humanities Style

Uçkun, Utkucan, and Firdevs Baş and Şükran Poyrazoğlu and Nur Mine Şükür and Fatma Feyza Darendeliler and Rüveyde Bundak. “Etiologic Evaluation of Severe Short Stature in Children at a Tertiary Pediatric Endocrinology Centre.” Journal of Child 19, no. 2 (Dec. 2024): 63-76. https://doi.org/10.5222/j.child.2019.18942


Harvard: Australian Style

Uçkun, U & Baş, F & Poyrazoğlu, Ş & Şükür, NM & Darendeliler, FF & Bundak, R 2019, 'Etiologic Evaluation of Severe Short Stature in Children at a Tertiary Pediatric Endocrinology Centre', Journal of Child, vol. 19, no. 2, pp. 63-76, viewed 23 Dec. 2024, https://doi.org/10.5222/j.child.2019.18942


Harvard: Author-Date Style

Uçkun, U. and Baş, F. and Poyrazoğlu, Ş. and Şükür, N.M. and Darendeliler, F.F. and Bundak, R. (2019) ‘Etiologic Evaluation of Severe Short Stature in Children at a Tertiary Pediatric Endocrinology Centre’, Journal of Child, 19(2), pp. 63-76. https://doi.org/10.5222/j.child.2019.18942 (23 Dec. 2024).


MLA

Uçkun, Utkucan, and Firdevs Baş and Şükran Poyrazoğlu and Nur Mine Şükür and Fatma Feyza Darendeliler and Rüveyde Bundak. “Etiologic Evaluation of Severe Short Stature in Children at a Tertiary Pediatric Endocrinology Centre.” Journal of Child, vol. 19, no. 2, 2019, pp. 63-76. [Database Container], https://doi.org/10.5222/j.child.2019.18942


Vancouver

Uçkun U, Baş F, Poyrazoğlu Ş, Şükür NM, Darendeliler FF, Bundak R. Etiologic Evaluation of Severe Short Stature in Children at a Tertiary Pediatric Endocrinology Centre. Journal of Child [Internet]. 23 Dec. 2024 [cited 23 Dec. 2024];19(2):63-76. Available from: https://doi.org/10.5222/j.child.2019.18942 doi: 10.5222/j.child.2019.18942


ISNAD

Uçkun, Utkucan - Baş, Firdevs - Poyrazoğlu, Şükran - Şükür, NurMine - Darendeliler, FatmaFeyza - Bundak, Rüveyde. “Etiologic Evaluation of Severe Short Stature in Children at a Tertiary Pediatric Endocrinology Centre”. Journal of Child 19/2 (Dec. 2024): 63-76. https://doi.org/10.5222/j.child.2019.18942



TIMELINE


Published Online31.08.2019

LICENCE


Attribution-NonCommercial (CC BY-NC)

This license lets others remix, tweak, and build upon your work non-commercially, and although their new works must also acknowledge you and be non-commercial, they don’t have to license their derivative works on the same terms.


SHARE




Istanbul University Press aims to contribute to the dissemination of ever growing scientific knowledge through publication of high quality scientific journals and books in accordance with the international publishing standards and ethics. Istanbul University Press follows an open access, non-commercial, scholarly publishing.