Growth Failure Treatment & Management

  • Author: Stephen Kemp, MD, PhD; Chief Editor: Bruce Buehler, MD   more...
 
Updated: Apr 13, 2012
 

Medical Care

Treatment is directed at the cause of the growth failure. If the child is diagnosed with hypothyroidism, treatment is thyroid hormone replacement. Likewise, if the child is diagnosed with growth hormone (GH) deficiency, the treatment is growth hormone replacement therapy. In 2003, the FDA approved the use of growth hormone for children who are not growth hormone deficient but who are at least 2.25 standard deviations below the mean for height, who are unlikely to have an adult height above -2 standard deviations, and who have no explanation for their short stature. This disorder has been termed idiopathic short stature.

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Consultations

Although a primary care physician often initiates the workup, the child is usually referred to an endocrinologist for a more detailed investigation of possible causes for growth failure.

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Contributor Information and Disclosures
Author

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.

Coauthor(s)

Neslihan Gungor, MD  Instructor, Department of Pediatrics, Section of Endocrinology, Children's Hospital of Pittsburgh and University of Pittsburgh

Neslihan Gungor, MD is a member of the following medical societies: American Academy of Pediatrics and American Association of Clinical Endocrinologists

Disclosure: Nothing to disclose.

Specialty Editor Board

Thomas A Wilson, MD  Professor of Clinical Pediatrics, Chief and Program Director, Division of Pediatric Endocrinology, Department of Pediatrics, The School of Medicine at Stony Brook University Medical Center

Thomas A Wilson, MD is a member of the following medical societies: Endocrine Society, Pediatric Endocrine Society, and Phi Beta Kappa

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.

George P Chrousos, MD, FAAP, MACP, MACE, FRCP(London)  Professor and Chair, First Department of Pediatrics, Athens University Medical School, Aghia Sophia Children's Hospital, Greece; UNESCO Chair on Adolescent Health Care, University of Athens, Greece

George P Chrousos, MD, FAAP, MACP, MACE, FRCP(London) is a member of the following medical societies: American Academy of Pediatrics, American College of Endocrinology, American College of Physicians, American Pediatric Society, American Society for Clinical Investigation, Association of American Physicians, Endocrine Society, Pediatric Endocrine Society, and 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

Bruce Buehler, MD  Professor, Department of Pediatrics and Genetics, Director RSA, University of Nebraska Medical Center

Bruce Buehler, MD is a member of the following medical societies: American Academy for Cerebral Palsy and Developmental Medicine, American Academy of Pediatrics, American Association on Mental Retardation, American College of Medical Genetics, American College of Physician Executives, American Medical Association, and Nebraska Medical Association

Disclosure: Nothing to disclose.

References

  1. [Guideline] New York State Department of Health. Growth, body composition, and metabolism. New York (NY): New York State Department of Health; 2007 Nov. [Full Text].

  2. Lindsay R, Feldkamp M, Harris D. Utah Growth Study: growth standards and the prevalence of growth hormone deficiency. J Pediatr. Jul 1994;125(1):29-35. [Medline].

  3. Lacey KA, Parkin JM. Causes of short stature. A community study of children in Newcastle upon Tyne. Lancet. Jan 12 1974;1(7846):42-5. [Medline].

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  5. Lem AJ, Jobse I, van der Kaay DC, de Ridder MA, Raat H, Hokken-Koelega AC. Health-Related Quality of Life in Short Children Born Small for Gestational Age: Effects of Growth Hormone Treatment and Postponement of Puberty. Horm Res Paediatr. Mar 21 2012;[Medline].

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  9. Hindmarsh PC, Brook CG. Short stature and growth hormone deficiency. Clin Endocrinol (Oxf). Aug 1995;43(2):133-42. [Medline].

  10. Hintz RL. Growth hormone treatment of idiopathic short stature. Horm Res. 1996;46(4-5):208-14. [Medline].

  11. Hintz RL. Disorders of growth. In: Brunwald E, Fauci AS, Isselbacher KJ, et al, eds. Harrison's Principles of Internal Medicine. 13th ed. New York, NY: McGraw-Hill Medical Publishing Division; 1994.

  12. 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].

  13. Kojima M, Hosoda H, Date Y. Ghrelin is a growth-hormone-releasing acylated peptide from stomach. Nature. Dec 9 1999;402(6762):656-60. [Medline].

  14. Kojima M, Hosoda H, Matsuo H. Ghrelin: discovery of the natural endogenous ligand for the growth hormone secretagogue receptor. Trends Endocrinol Metab. Apr 2001;12(3):118-22. [Medline].

  15. Stabler B, Clopper RR, Siegel PT, et al. Academic achievement and psychological adjustment in short children. The National Cooperative Growth Study. J Dev Behav Pediatr. Feb 1994;15(1):1-6. [Medline].

  16. Stabler B, Siegel PT, Clopper RR, et al. Behavior change after growth hormone treatment of children with short stature. J Pediatr. Sep 1998;133(3):366-73. [Medline].

  17. Tanner JM. Fetus into Man: Physical Growth from Conception to Maturity. Cambridge, Mass: Harvard University Press; 1990.

  18. Tanner JM. Normal growth and techniques of growth assessment. Clin Endocrinol Metab. Aug 1986;15(3):411-51. [Medline].

  19. Zemel B. The recognition and treatment of growth disorders - a 50-year retrospective. Ann Hum Biol. Sep-Oct 2009;36(5):496-510. [Medline].

 
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Growth failure in length and weight with a normal head circumference in an infant with growth hormone deficiency.
 
 
 
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