Causes of Short Stature in Children Referred to a Tertiary Care Center in Southeast of Iran: 2018-2020

Abstract

Background: Short stature is a common problem encountered by endocrinologists. Short stature may be due to normal variations of growth or pathologic process. Evaluation of short stature and its causes in any community can be effective in reducing physical and mental illness in children. Objectives: The objective of this study was to evaluate the frequency of common causes of short stature in children referring to the endocrinology clinic. Methods: This prospective and descriptive study was carried out between August 2018 and September 2020. Included criteria were age below 18 years, height more than 2 SD below the mean for age (< 3rd percentile), growth failure (< 4 cm/year), small for mid-parental height, and adequate follow-up. They were evaluated by anthropometric measurements, biochemical panel, hormonal tests, radiological studies, and hormonal provocative tests. Results: A total of 509 cases, including 238 males (46.8%) and 271 females (53.2%) had short stature. The age of participants varied from 2-18 years. The mean chronological age was 11.83±3.44 years. Most study participants were over 10 years old (68%). Normal variants of growth with 271 (53.34%) children, were the most prevalent causes. These causes were in three subgroups: familial short stature: 133 (26.14%), constitutional delay of growth and puberty: 112 (22%), and idiopathic short stature: 26 (5.12%). Totally 238 cases (46.66%) were due to pathologic types of short stature. The leading cause of short stature in this group was growth hormone deficiency, which was seen in 70 (13.76%) patients. Conclusions: The normal variants of short stature as a group were the most common cause of short stature, followed by endocrinological causes of short stature and non-endocrinological causes.