Abstract
Short stature is a clinical challenge in the daily practice of pediatric endocrinology, regarding the several technical, cultural and economic factors associated with its approach. This article intends to review the physiology of growth hormone secretion, the endocrine regulation of human growth and the clinical aspects of the diagnosis and treatment of short stature. It specifically analyses the treatment of short stature with growth hormone, along with its side effects, cost/benefit analysis and possible risks. A clinical case from a medical school is also described, intending a better understanding of this frequent ambulatory situation in endocrinology and pediatrics.
Highlights
The dynamics of the growth process are affected by intrinsic and extrinsic factors, which define the final height and the rate and the growth spurt
The detection of unexplained acceleration or deceleration in the growth rate, or the adoption of a curve different from that expected from family background, requires investigation; changes in endocrine function are an important part of the investigation, but do not fully account for the differential diagnosis of abnormal growth
Short stature due to growth hormone deficiency is a complex clinical situation that requires expertise, knowledge regarding the history of disease and a thorough analysis of the available treatment options, according to the best scientific evidences, avoiding off-label therapies or unproved alternatives
Summary
The dynamics of the growth process are affected by intrinsic and extrinsic factors, which define the final height and the rate and the growth spurt. Good pediatric care includes careful clinical monitoring of growth, which is a sensitive marker of health and well-being. The detection of unexplained acceleration or deceleration in the growth rate, or the adoption of a curve different from that expected from family background, requires investigation; changes in endocrine function are an important part of the investigation, but do not fully account for the differential diagnosis of abnormal growth. (2016) Understanding Growth Hormone Secretion and Short Stature. Open Journal of Endocrine and Metabolic Diseases, 6, 78-86. A clinical case followed by the IPEMED Medical School, located at São Paulo, Brazil, from the endocrinology ambulatory clinic was used for reference
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