Short stature refers to a child whose height is ≥2 standard deviations below the mean for sex and age and may be a normal growth variant or secondary to underlying disease. Normal variants of growth failure include:
Familial short stature – Low-normal growth velocity throughout life with normal bone age.
Constitutional growth delay – Results in childhood short stature, as children grow at a low-normal rate but have normal adult height. Puberty is typically delayed, with bone age correlating to height age.
Idiopathic short stature – Height below 2 standard deviations of the mean for age and sex without identifiable underlying cause.
In addition, there are several pathologic causes of growth failure including:
Undernutrition – Low height-for-weight with inadequate caloric intake.
Glucocorticoid therapy – Causes decreased growth via interference of endogenous growth hormone secretion and bone formation. Catch-up growth may occur with cessation of steroids.
Renal disease – Growth failure is seen in 1/3 children with renal disease due to dietary restrictions, anorexia, uremia, metabolic acidosis, or use of steroids for treatment.
Rheumatologic disease – Conditions, especially juvenile idiopathic arthritis, are associated with growth failure thought to be secondary to inflammatory cytokines and corticosteroid therapy.
Cancer – Poor growth can be seen during treatment for cancer due to negative side effects of chemotherapy, although catch-up growth may be seen once therapy is completed. Late effects of cranial radiation therapy may be seen due to hypothalamic damage.
Codes
ICD10CM: P05.9 – Newborn affected by slow intrauterine growth, unspecified
SNOMEDCT: 444896005 – Growth Retardation
Differential Diagnosis & Pitfalls
See the synopsis for a list of the differential diagnosis for growth retardation.
Best Tests
Subscription Required
Drug Reaction Data
Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.
