Constitutional Growth Delay Medication

  • Author: Pamela A Clark, MD; Chief Editor: Stephen Kemp, MD, PhD   more...
 
Updated: Aug 19, 2011
 

Medication Summary

Because constitutional growth delay (CGD) is not a disorder but rather a variation of normal growth, medical treatment is not necessary. However, short courses of sex hormones are an option for those patients experiencing psychological distress because of their delay in growth and development. In males, androgens can be used to accelerate linear growth and onset of pubertal changes. When used appropriately, no detrimental effects on adult height are evident. Therapy does not increase adult stature. Guidelines have been established for children in whom growth hormone (GH) therapy is indicated.[4]

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Anabolic steroids

Class Summary

These agents promote growth and sexual maturation.

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Testosterone (Delatestryl, Depo-Testosterone)

 

Depot preparation of testosterone available as enanthate or cypionate salt. Available in multiuse vial for IM injection. Transdermal preparations are available and have been used successfully in this context, although no established protocols are available.

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Contributor Information and Disclosures
Author

Pamela A Clark, MD  Consulting Staff, McLeod Physician Associates; Consulting Staff, McLeod Pediatric Subspecialists

Pamela A Clark, MD is a member of the following medical societies: American Academy of Pediatrics, American Association of Clinical Endocrinologists, and Pediatric Endocrine Society

Disclosure: Nothing to disclose.

Specialty Editor Board

Arlan L Rosenbloom, MD  Adjunct Distinguished Service Professor Emeritus of Pediatrics, University of Florida College of Medicine; Fellow of the American Academy of Pediatrics; Fellow of the American College of Epidemiology

Arlan L Rosenbloom, MD is a member of the following medical societies: American Academy of Pediatrics, American College of Epidemiology, American Pediatric Society, Endocrine Society, Florida Pediatric Society, Pediatric Endocrine Society, and Society for Pediatric Research

Disclosure: Nothing to disclose.

Mary L Windle, PharmD  Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Barry B Bercu, MD  Professor, Departments of Pediatrics, Molecular Pharmacology and Physiology, University of South Florida College of Medicine, All Children's Hospital

Barry B Bercu, MD is a member of the following medical societies: American Academy of Pediatrics, American Association of Clinical Endocrinologists, American Federation for Clinical Research, American Medical Association, American Pediatric Society, Association of Clinical Scientists, Endocrine Society, Florida Medical Association, Pediatric Endocrine Society, Pituitary Society, Society for Pediatric Research, Society for the Study of Reproduction, and Southern Society for Pediatric Research

Disclosure: Nothing to disclose.

Merrily P M Poth, MD  Professor, Department of Pediatrics and Neuroscience, Uniformed Services University of the Health Sciences

Merrily P M Poth, MD is a member of the following medical societies: American Academy of Pediatrics, Endocrine Society, and Pediatric Endocrine Society

Disclosure: Nothing to disclose.

Chief Editor

Stephen Kemp, MD, PhD  Professor, Department of Pediatrics, Section of Pediatric Endocrinology, University of Arkansas for Medical Sciences College of Medicine, Arkansas Children's Hospital

Stephen Kemp, MD, PhD is a member of the following medical societies: American Academy of Pediatrics, American Association of Clinical Endocrinologists, American Pediatric Society, Endocrine Society, Phi Beta Kappa, Southern Medical Association, and Southern Society for Pediatric Research

Disclosure: Nothing to disclose.

References

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  2. Banerjee I, Hanson D, Perveen R, Whatmore A, Black GC, Clayton PE. Constitutional delay of growth and puberty is not commonly associated with mutations in the acid labile subunit gene. Eur J Endocrinol. Apr 2008;158(4):473-7. [Medline].

  3. Doneray H, Orbak Z. Association between bone turnover markers and bone mineral density in puberty and constitutional delay of growth and puberty. West Indian Med J. Jan 2008;57(1):33-9. [Medline].

  4. [Best Evidence] [Guideline] Wilson TA, Rose SR, Cohen P, et al. Update of guidelines for the use of growth hormone in children: the Lawson Wilkins Pediatric Endocrinology Society Drug and Therapeutics Committee. J Pediatr. Oct 2003;143(4):415-21. [Medline].

  5. Bierich JR. Constitutional delay of growth and adolescence. Baillieres Clin Endocrinol Metab. Jul 1992;6(3):573-88. [Medline].

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  7. Crowne EC, Shalet SM, Wallace WH, Eminson DM, Price DA. Final height in boys with untreated constitutional delay in growth and puberty. Arch Dis Child. Oct 1990;65(10):1109-12. [Medline].

  8. Hagg U, Taranger J. Pubertal growth and maturity pattern in early and late maturers. A prospective longitudinal study of Swedish urban children. Swed Dent J. 1992;16(5):199-209. [Medline].

  9. Horner JM, Thorsson AV, Hintz RL. Growth deceleration patterns in children with constitutional short stature: an aid to diagnosis. Pediatrics. Oct 1978;62(4):529-34. [Medline].

  10. Krupa B, Miazgowski T. Bone mineral density and markers of bone turnover in boys with constitutional delay of growth and puberty. J Clin Endocrinol Metab. May 2005;90(5):2828-30. [Medline].

  11. Leschek EW, Rose SR, Yanovski JA, et al. Effect of growth hormone treatment on adult height in peripubertal children with idiopathic short stature: a randomized, double-blind, placebo-controlled trial. J Clin Endocrinol Metab. Jul 2004;89(7):3140-8. [Medline].

  12. Miller BS, Zimmerman D. Idiopathic short stature in children. Pediatr Ann. Mar 2004;33(3):177-81. [Medline].

  13. Poyrazoglu S, Gunoz H, Darendeliler F, Saka N, Bundak R, Bas F. Constitutional delay of growth and puberty: from presentation to final height. J Pediatr Endocrinol Metab. Feb 2005;18(2):171-9. [Medline].

  14. Racine MS, Symons KV, Foster CM, Barkan AL. Augmentation of growth hormone secretion after testosterone treatment in boys with constitutional delay of growth and adolescence: evidence against an increase in hypothalamic secretion of growth hormone-releasing hormone. J Clin Endocrinol Metab. Jul 2004;89(7):3326-31. [Medline]. [Full Text].

  15. Ranke MB, Aronson AS. Adult height in children with constitutional short stature. Acta Paediatr Scand Suppl. 1989;362:27-31. [Medline].

  16. Rosenfeld RG, Northcraft GB, Hintz RL. A prospective, randomized study of testosterone treatment of constitutional delay of growth and development in male adolescents. Pediatrics. Jun 1982;69(6):681-7. [Medline].

  17. Yap F, Hogler W, Briody J, et al. The skeletal phenotype of men with previous constitutional delay of puberty. J Clin Endocrinol Metab. Sep 2004;89(9):4306-11. [Medline]. [Full Text].

  18. Zachmann M, Studer S, Prader A. Short-term testosterone treatment at bone age of 12 to 13 years does not reduce adult height in boys with constitutional delay of growth and adolescence. Helv Paediatr Acta. Jun 1987;42(1):21-8. [Medline].

 
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Comparison of the growth patterns between idiopathic short stature and constitutional growth delay.
 
 
 
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