%0 Journal Article
%T The Evaluation and Followup of Children Referred to Pediatric Endocrinologists for Short Stature
%A David Wyatt
%A Katrina L Parker
%A Stephen F Kemp
%A Jane Chiang
%A D Davis
%J International Journal of Pediatric Endocrinology
%D 2010
%I BioMed Central
%R 10.1155/2010/652013
%X Growth can be used as a proxy for a child's health, nutrition, and psychosocial well being. In the United States, approximately 2.2 million children under 18 years of age have heights below the third percentile [1]. Most will be healthy, but a minority will have a pathologic etiology for their short stature. Among the short-statured children who are referred to a pediatric endocrinologist for the evaluation of growth failure, only a minority are treated with recombinant human growth hormone (rhGH). The clinical characteristics of those who are evaluated for growth failure but do not receive rhGH treatment are unknown.When first seeing a short-statured referral, the pediatric endocrinologist must determine which patient requires prompt extensive evaluation versus more conservative monitoring. This decision is based on a combination of history, genetic growth potential, prior laboratory testing, and the degree of growth failure observed. Unfortunately, the available growth records at the time of referral can often be incomplete [2]. Forward monitoring of the child's untreated growth rate could be a valuable part of the evaluation. However, the percentage of children who return for such monitoring and the extent of laboratory screening eventually performed are unknown.The diagnostic and therapeutic approach to a patient with short stature may differ among pediatric endocrinologists. In 1995, a written survey was distributed to pediatric endocrinologists in an attempt to determine the degree of variability in the evaluation of the short child [3]. The survey asked the 251 respondents (413 surveys distributed; 61% response rate) to identify which screening tests were most commonly used to aid in the diagnosis of growth failure and to obtain feedback about recommendations for follow-up care. The survey found that the majority of endocrinologists stated that they were using a similar approach, especially in regards to laboratory assessment. However, it is not known whether
%U http://www.ijpeonline.com/content/2010/1/652013