Affiliation:
1. Department of Endocrinology, Great Ormond Street Hospital for Children, WC1N 1EH, London, United Kingdom
2. Department of Internal Medicine and Therapeutics, Pediatrics and Adolescent Care Unit, University of Pavia, Strada Nuova 65, 27100 Pavia, Italy
Abstract
Clinicians generally use the term “tall stature” to define a height more than two standard
deviations above the mean for age and sex. In most cases, these subjects present with familial tall
stature or a constitutional advance of growth which is diagnosed by excluding the other conditions
associated with overgrowth. Nevertheless, it is necessary to be able to identify situations in which
tall stature or an accelerated growth rate indicate an underlying disorder. A careful physical evaluation
allows the classification of tall patients into two groups: those with a normal appearance and
those with an abnormal appearance including disproportion or dysmorphism. In the first case, the
growth rate has to be evaluated and, if it is normal for age and sex, the subjects may be considered
as having familial tall stature or constitutional advance of growth or they may be obese, while if the
growth rate is increased, pubertal status and thyroid function should be evaluated. In turn, tall subjects
having an abnormal appearance can be divided into proportionate and disproportionate syndromic
patients. Before initiating further investigations, the clinician needs to perform both a careful
physical examination and growth evaluation. To exclude pathological conditions, the cause of
tall stature needs to be considered, although most children are healthy and generally do not require
treatment to inhibit growth progression.
In particular cases, familial tall stature subject can be treated by inducing puberty early and leading
to a complete fusion of the epiphyses, so final height is reached. This review aims to provide
proposals about the management of tall children.
Publisher
Bentham Science Publishers Ltd.
Subject
Pediatrics, Perinatology, and Child Health
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