Short Kids

Children diagnosed with a growth disorder are now routinely treated with growth hormone therapy. But since two years ago the Federal Drug Administration (FDA) approved the use of synthetic growth hormone to treat children identified as abnormally short but otherwise healthy, parents and physicians have faced a dilemma. Should a child receive frequent and costly injections of growth hormone in hopes of gaining more height?

When a child is significantly shorter than other children of the same age, it often dismays parents and prompts them to seek medical help. While many children are genetically destined to be short, some are indeed diagnosed with a medical disorder that is causing growth failure. Still others are labeled “idiopathic short-statured (ISS),” meaning there is no known cause for their abnormal height.

Dr. David R. Brown, who practices pediatric endocrinology and metabolism at Children’s Hospitals and Clinics in Minneapolis, and is also a professor of pediatrics at the University of Minnesota, says a diagnosis of ISS is commonly misunderstood. It does not necessarily mean there is no underlying medical problem. “Idiopathic patients are those who clinically meet all the criteria that define deficiency,” he says, “but they have a normal level of growth hormone.”

Dr. Brown explains the tests used to measure growth hormone levels in the blood cannot pinpoint other physiological problems that may inhibit release of the hormone. So although a child may score in the normal range on laboratory tests, there may still be an unidentified growth deficiency.