THU175 Incorrect Age Causing Falsely Short Stature In An Afghan Immigrant Girl

Abstract

Abstract Disclosure: J. Ing: None. M. Marinkovic: None. Background: Evaluation for short stature routinely includes screening for hormone deficiencies, chromosomal abnormalities, gastroenterological diseases, and inflammatory processes. “Incorrect age” resulting in falsely short stature, is not often considered in the differential diagnosis. Clinical Case: A young girl who recently immigrated to the United States from Afghanistan was referred for endocrine evaluation for short stature. At the time of her initial visit, she was listed in the electronic medical record at 10 years and 0 months old. Her medical history was significant for bowel injuries sustained three years prior in a bombing incident that required surgery and from which she completely recovered. Available growth charts from the preceding 6 months showed height and weight consistently less than the 1st percentile for her age but normal height velocity. On the exam she was prepubertal. Her measured height was 117.8 cm (0.06th percentile, Z = -3.24) and her body mass index (BMI) was 14.7 kg/m2 (12th percentile, Z = -1.18). The patient’s calculated mid-parental height was 155.5 cm (12.5th percentile, Z = -1.15). Laboratory work-up obtained by the pediatrician showed normal IGF-1, IGFBP-3, TSH, free and total thyroxine, tissue transglutaminase IgA, sedimentation rate, urinalysis, complete blood panel, complete metabolic panel, and a normal 20 cell count karyotype (46, XX). Her bone age was 5 years and 6 months and was interpreted as markedly delayed. Upon further history gathering using a Pashto interpreter, her father revealed there was an error in the processing of her immigration documents, resulting in being listed as three years older than her actual age. When corrected to that of a 7 year and 0 month old girl, her height improved to the 23rd percentile (Z = -0.73), and her BMI to the 31st percentile (Z = -0.5). Conclusion: This case demonstrates how children, through the immigration process, may have their age incorrectly documented and thereby are at risk for unnecessary and costly medical evaluation. It is possible that language barriers play a role in such errors. Therefore, it is important to verify the patient's true age, as parents may not think to provide this information voluntarily. Presentation: Thursday, June 15, 2023