The most common causes of short stature are non-pathological conditions (ie, there is no underlying disease or hormonal problem to prevent growth). The first of these is what we call structural delay in height growth and puberty. These children are shorter than their peers, but their bone age is also behind. They enter puberty late, but after they enter, they catch up with their peers by taller. These usually do not require any treatment. If puberty is too delayed, puberty can be initiated with short-term low-dose puberty hormone therapy.
Here, without any medical problems, the child is also short because the mother, father or both are short. In these children, the bone age is equal to the calendar age. In other words, there is no bone age retardation. The birth weight of the child may also be low, especially if the mother is short. This may further increase the short stature. There is no effective and satisfactory treatment for familial short stature.
Some of the babies born with low birth weight are babies who are not well fed and cannot develop due to placental insufficiency during pregnancy. Some have syndromic and genetic causes. The child should be carefully evaluated in terms of underlying causes. Growth hormone therapy may be considered after 4 years of age in severe short stature due to low birth weight.
Another important cause of short stature is disproportionate short stature that occurs due to congenital defects in bone structure. These are called skeletal dysplasias. In some of them, for example, a certain degree of improvement can be achieved with drug treatment in the disease known as glass bone disease. However, in a significant portion of congenital defects in bone structure, drug treatments have no place in height. In these children, bone lengthening operations can be performed by experienced orthopedic specialists in order to reduce the disproportion and increase the height. However, these are extremely laborious and difficult operations.
Turner syndrome is an important cause of short stature, especially in girls. It manifests itself with short stature and delayed puberty. In addition, there may be some additional symptoms such as short neck, swelling in the hands and feet at birth, horseshoe kidney, frequent otitis media, and excessive mole formation on the skin. Growth hormone and puberty hormone therapy after the age of 12 are used in the treatment of Turner syndrome.