Constitutional Growth Delay Treatment & Management
- Author: Pamela A Clark, MD; Chief Editor: Stephen Kemp, MD, PhD more...
Medical care in constitutional growth delay (CGD) is aimed at obtaining several careful growth measurements at frequent intervals, often every 6 months. These measurements are used to calculate linear height velocities and establish a trajectory on the growth curve. Medical treatment of this variation of normal growth is not necessary but may be initiated in adolescents experiencing psychosocial distress (see Medication).
No special dietary requirements are necessary, although a balanced diet with adequate calories and calcium intake is recommended to support normal growth and bone development.
No restrictions on activity are necessary. However, adolescents with constitutional growth delay who participate in contact sports must realize their limitations in competition with larger, stronger peers. Adolescents who wish to participate in weight lifting or resistance-training activities should use lower weights with greater repetitions to avoid undue stress on immature growth plates.
Sultan M, Afzal M, Qureshi SM, et al. Etiology of short stature in children. J Coll Physicians Surg Pak. 2008 Aug. 18(8):493-7. [Medline].
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. 2008 Apr. 158(4):473-7. [Medline].
Rogol AD, Hayden GF. Etiologies and early diagnosis of short stature and growth failure in children and adolescents. J Pediatr. 2014 May. 164(5 Suppl):S1-14.e6. [Medline].
Gunn KC, Cutfield WS, Hofman PL, Jefferies CA, Albert BB, Gunn AJ. Constitutional delay influences the auxological response to growth hormone treatment in children with short stature and growth hormone sufficiency. Sci Rep. 2014 Aug 14. 4:6061. [Medline].
Rohayem J, Nieschlag E, Kliesch S, Zitzmann M. Inhibin B, AMH, but not INSL3, IGF1 or DHEAS support differentiation between constitutional delay of growth and puberty and hypogonadotropic hypogonadism. Andrology. 2015 Sep. 3 (5):882-7. [Medline].
McGrath N, O'Grady MJ. Aromatase inhibitors for short stature in male children and adolescents. Cochrane Database Syst Rev. 2015 Oct 8. 10:CD010888. [Medline].
Harrington J, Palmert MR. Clinical review: Distinguishing constitutional delay of growth and puberty from isolated hypogonadotropic hypogonadism: critical appraisal of available diagnostic tests. J Clin Endocrinol Metab. 2012 Sep. 97(9):3056-67. [Medline].
Krebs A, Moske-Eick O, Doerfer J, Roemer-Pergher C, van der Werf-Grohmann N, Schwab KO. Marked increase of final height by long-term aromatase inhibition in a boy with idiopathic short stature. J Pediatr Endocrinol Metab. 2012. 25(5-6):581-5. [Medline].
Cook DM, Rose SR. A review of guidelines for use of growth hormone in pediatric and transition patients. Pituitary. 2012 Sep. 15 (3):301-10. [Medline].
[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. 2003 Oct. 143(4):415-21. [Medline].
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. 2008 Jan. 57(1):33-9. [Medline].
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. 2005 May. 90(5):2828-30. [Medline].
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. 2004 Jul. 89(7):3140-8. [Medline].
Miller BS, Zimmerman D. Idiopathic short stature in children. Pediatr Ann. 2004 Mar. 33(3):177-81. [Medline].
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. 2005 Feb. 18(2):171-9. [Medline].
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].
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].
Wit JM, Oostdijk W. Novel approaches to short stature therapy. Best Pract Res Clin Endocrinol Metab. 2015 Jun. 29 (3):353-66. [Medline].