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Investigation of the slowly growing child 

Investigation of the slowly growing child
Chapter:
Investigation of the slowly growing child
Author(s):

L. Patel

and P. E. Clayton

DOI:
10.1093/med/9780199235292.003.7057
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date: 14 November 2019

Reduced height velocity for age and stage of puberty implies slow growth. Although this occurs independently from actual height, children identified for investigation tend to be the ones who are slowly growing, as well as short. The majority of short slowly growing children do not have a recognized endocrinopathy. The commonest growth disorders are those grouped under the heading ‘idiopathic’, which includes constitutional delay in growth and puberty, a disorder of the tempo of maturation, and familial/genetic short stature. These children present with short stature, an unremarkable phenotype, and a variable extent of growth failure. The challenge to the clinician is to differentiate these children from those who may have a defined nonendocrine pathology (for example, chronic systemic disease (Box 7.2.4.1), bone disorder, or psychosocial problem) and those who may have an abnormality within the growth hormone axis.

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