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Should idiopathic short stature be treated with growth hormone?

Nature Reviews Endocrinology volume 5, pages 148–149 (2009)Cite this article

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Idiopathic short stature (ISS) describes a group of conditions associated with subnormal height that lack a primary defect of the growth plate or a secondary defect of growth-plate physiology.1 ISS is not a clinical diagnosis, but rather a descriptive category that encompasses a variety of unidentified causes. From a clinical perspective, ISS describes a short child (<–2 SD for age and population) with normal growth hormone (GH) secretion and birth size, no dysmorphic syndrome, and no chronic or psychiatric illness.2 Gene mutations have, however, been identified in some patients categorized as having ISS.3,4

Although ISS is an important entity within pediatric endocrinology, its heterogeneous nature makes clinical management a challenge. A consensus group agreed that subcategorization of ISS on the basis of auxological criteria might help determine the appropriate therapy.5 Children with familial short stature should be distinguished from those whose condition does not have an obvious familial component. The presence of bone age delay must also be identified, as such a postponement can be indicative of delayed growth and puberty, with a greater than expected adult height.

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Author notes

  1. Department of Endocrinology, John Vane Science Centre, Charterhouse Square, London EC1M 6BQ, UK m.o.savage@qmul.ac.uk

Authors and Affiliations

  1. MO Savage is Professor (Emeritus) of Pediatric Endocrinology in the Department of Endocrinology, William Harvey Research Institute, Barts and the Royal London School of Medicine and Dentistry, London, UK.,

    Martin O Savage

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  1. Martin O Savage
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Competing interests

Martin O Savage declared the following associations: Ipsen (consultant, speakers bureau); Merck Serono (speakers bureau); Novo Nordisk (speakers bureau); Pfizer (speakers bureau); and Tercica (speakers bureau).

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Savage, M. Should idiopathic short stature be treated with growth hormone?. Nat Rev Endocrinol 5, 148–149 (2009). https://doi.org/10.1038/ncpendmet1074

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