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Italian Journal of Pediatrics

, 43:66

Endocrinology

Abstract

Referral for an assessment of tall stature is less common than for short stature. Tall stature is defined as a height more than two standard deviations above the mean for age. The majority of subjects with tall stature show a familial tall stature or a constitutional advance of growth CAG, which is a diagnosis of exclusion. After a careful physical evaluation, tall subjects may be divided into two groups: tall subjects with normal appearance and tall subjects with abnormal appearance. In the case of normal appearance, the paediatric endocrinologist will have to evaluate the growth rate. If it is normal for age and sex, the subject may be classified as having familial tall stature, CAG or obese subject, while if the growth rate is increased it is essential to evaluate pubertal status and thyroid status. Tall subjects with abnormal appearance and dysmorphisms can be classified into those with proportionate and disproportionate syndromes.

A careful physical examination and an evaluation of growth pattern are required before starting further investigations. Physicians should always search for a pathological cause of tall stature, although the majority of children are healthy and they generally do not need treatment to cease growth progression.

The most accepted and effective treatment for an excessive height prediction is inducing puberty early and leading to a complete fusion of the epiphyses and achievement of final height, using testosterone in males and oestrogens in females. Alternatively, the most common surgical procedure for reducing growth is bilateral percutaneous epiphysiodesis of the distal femur and proximal tibia and fibula.

This review aims to provide up-to-date information and suggestions about the diagnosis and management of children with tall stature.

KeywordsTall stature Syndromes Growth velocity Puberty Height AbbreviationsCBSCystathionine β-synthase

ERαOestrogen receptor α

FSHFollicle stimulating hormone

GHGrowth hormone

GnRHGonadotropin releasing hormone

IGF-IInsulin-like growth factor-I

LHLuteinizing hormone

MPHMidparental height

SDStandard deviation

SDSStandard deviation score

TSHThyroid stimulating hormone

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Author: Cristina Meazza - Chiara Gertosio - Roberta Giacchero - Sara Pagani - Mauro Bozzola

Source: https://link.springer.com/







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