The Etiological Spectrum of Short Stature among Children Attending Endocrine Clinic at Tertiary Care Hospital

Abstract

Background: One of the most frequent reasons for referral to pediatric endocrinology units is short stature. Children's short height has a complicated etiology that includes genetics, race, gender, nutrition, and several endocrine hormones. Objective: To determine the etiological spectrum of short stature among children presenting to endocrinology outpatient clinics in a tertiary care hospital. Methods: This descriptive cross-sectional study was performed in the outpatient clinic of the Endocrinology Department at the National Institute of Child Health Hospital from September to December 2022. Short stature was defined as height for age <-2 standard deviations for the corresponding age and gender according to World Health Organization growth charts. 263 children were enrolled in the study. Detailed history and panel investigation for short stature were mediated for each child. Results: A total of 263 patients were enrolled in the study having a median age of 8 (IQR=6-9) years and the majority were females (53.2%). The median SD of height and current weight was -3.48 (IQR= -4.3 - -2.83) and -2.8 (IQR= -3.59 - -2.17) respectively. The most frequently seen classification of short stature was the normal variant (68.1%) followed by endocrine disorders (19.8%), dysmorphic syndrome (9.9%), and chronic disease (2.3%). The most common cause of short stature was familial short stature (47.9%) followed by growth hormone deficiency (18.3%), constitutional short stature (9.1%), Turner syndrome (9.1%), both familial and constitutional SS (8%), idiopathic short stature (3%), celiac disease (2.3%), Cushing syndrome (n=2, 0.8%), panhypopituitarism (0.8%) and Seckel syndrome (0.8%). Conclusion: This study analyzed that the majority of short stature are normal variants. However, findings of endocrine disorders, dysmorphic disorders, and chronic disease suggest timely screening and detection of short stature to avoid serious consequences of silent underlying diseases.