Medication Summary
Medication administered depends on the etiology of the short stature.
Growth Hormone
Class Summary
These agents improve symptoms associated with growth hormone deficiency (GHD).
Somatropin (Humatrope, Nutropin, Genotropin, Saizen, Tev-Tropin, Norditropin)
hGH produced via recombinant DNA technology in Escherichia coli; widely available since 1985. Currently, only 1 of the 10 largest reported clinical studies has demonstrated that therapy can increase final adult height in patients with normal variant short stature. This most recent NIH-funded study was randomized, placebo controlled, and took place over 14 y. Investigators demonstrated average gain in height did not exceed 4 cm when rhGH treatment of normal variant short stature began prior to puberty and continued through completion of puberty. They did not identify any clinical feature that, prior to start of therapy, could predict whether an individual patient would respond to rhGH and to what degree. Whether several years of daily injections are worth the potential, but not promised, relatively small increase in final adult height remains a personal and individual decision involving the patient, patient's family, and physician.
Insulin-like growth factor-I
Class Summary
Indicated for long-term treatment of severe, primary insulin-like growth factor-I (IGF-I) due to mutations of the growth hormone receptor (GH-R) or GH-R downstream signaling pathways.
Mecasermin (Increlex)
Recombinant human insulinlike growth factor-1 (rhIGF-1) indicated for long-term treatment of GF in children with severe primary IGFD (primary IGFD defined as basal serum IGF-I level and height SD scores ≤ -3, normal or elevated serum GH level). IGF-I is essential for normal growth of children's bones, cartilage, and organs by stimulating uptake of glucose, fatty acids, and amino acids into tissues. IGF-I is the principal hormone for linear growth and directly mediates GH actions. Primary IGFD is characterized by absent IGF-I production despite normal or elevated GH release.
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Proper use of a wall-mounted stadiometer.
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Comparison of the growth patterns between idiopathic short stature and constitutional growth delay.
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Bone age comparison between an 8-year-old boy (left) and a 14-year-old adolescent boy (right).
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Growth chart for Turner syndrome. Note that the upper limit overlaps the range for girls of normal height.
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A single, central, maxillary incisor reflects a defect in midline facial development.
