Constitutional Delay of Growth and Puberty

Abstract

Constitutional delay of growth and puberty (CDGP) is one of the most frequent reasons for referral of short children to pediatric endocrinologists. The cardinal features of CDGP are generally short stature with delayed skeletal maturation (usually in keeping with the height-age) and delayed sexual maturation (in keeping with the bone-age rather than chronologic age). Predicted adult heights are generally within the normal range for family, and no hormonal or biochemical evidence of disease is present. Many of these children are identified before the pubertal years and are referred to as having constitutional growth delay. Although CDGP has been considered a normal variant of growth and development, it is not without physical and psychosocial consequences. A relatively short sitting height is a consistent finding and contributes to a modest diminution of final adult stature. Although reduced bone mineral density has also been described, recent studies in adults with a history of CDGP suggests minimal impact on bone mineralization if skeletal size is factored into the measurement. Timely therapy in selected cases might have a beneficial affect by minimizing the negative psychosocial impact that frequently accompanies this condition.