lowstature

Low stature refers to having a height that is significantly below the average for a person's age and sex. Clinically, short stature is often defined as a height more than 2 standard deviations below the mean, or below the third percentile for age and sex, though definitions vary.

Not all short height indicates disease; many individuals have familial short stature with normal growth velocity. Determining whether a case is constitutional or due to an underlying condition requires evaluation.

Causes include genetic skeletal dysplasias (eg, achondroplasia, hypochondroplasia), chromosomal conditions (Turner syndrome), endocrine disorders (growth hormone deficiency, hypothyroidism, Cushing), systemic illness (chronic kidney disease, inflammatory disease), malnutrition, and psychosocial deprivation.

Evaluation includes documentation of growth velocity, plotting on standardized growth charts, assessment of pubertal stage, family height, physical examination for dysmorphic features, bone age assessment, and targeted laboratory tests (thyroid function, celiac screening, IGF-1, GH testing in appropriate settings). Imaging may be used to assess skeletal maturity and possible dysplasias.

Management depends on cause and may involve treatment of the underlying condition, nutrition optimization, and, in selected cases, growth hormone therapy or endocrine therapies under specialist care. Psychological and social support may be beneficial.

Prognosis varies by etiology; some conditions allow near-normal adult height with treatment or reach a finite short adult stature, while others are associated with persistent short stature and increased morbidity in certain conditions.

See also: short stature, growth hormone deficiency, Turner syndrome.