Endocrine Abstracts

Idiopathic short stature (ISS) is a condition characterized by a height more than 2 standard deviations below the corresponding average height for a given age, sex and population, without any identifiable systemic, endocrine, nutritional, or chromosomal disorder, and normal stimulated growth hormone (GH) levels. We report a case of a 17-years-old female, admitted to the hospital for endocrinology reevaluation. She was firsty reffered to endocrinologist for short stature at the age of 5 when laboratory and hormonal testing showed no abnormalities (normal hemogram, liver and renal function test, thyroid and cortisol axes; peak GH 20.6 μg/L). Her karyotype was a normal 46XX. Her birth height and weight were adequate but the past medical history was significant for 18 months imobilisation for Perthes disease at the age of 4. After primary evaluation, the patient avoided recommended regular checkups. According to her parents, her height velocity was 4.5 cm per year. She was reevaluated at the age of 11, when the anthropometric parameters showed height 125.5 cm (3rd percentile) and weight 46 kg (86 percentile). Laboratory investigations and hormonal analysis were without abnormalities. Her bone age was found to be at 10–10.5 years. On current admission, her height was 132.5 cm, weight 53 kg, body mass index (BMI) 30.42 kg/m², with waist and hip circumferences of 75.5 cm and 90 cm respectively. She achived menarche at age 11 with regular menstrual periods. Laboratory tests are still within normal limits. Her insulin-like growth factor (IGF)-1 level of 428 ng/dl was good and so the other hormonal analysis. This case focuses on clinical dilemmas raised during the irregular patient follow-up. The management of ISS remains a challenge since its treatment options are controversial. In documented studies, only modest evidence for efficacy with use of recombinant GH is noticed, but the therapy is generally not been shown to affect health related quality of life.