Investigation of tall stature in children: Diagnostic work-up, review of the main causes

Tall stature is not a common motive for medical consultation, even though by definition 2.5 % of children in the general population are concerned. It is usually defined as height greater than+2 standard deviations (SD) using the appropriate growth chart for age and gender, or a difference greater th...

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Bibliographic Details
Published in:Archives de pédiatrie : organe officiel de la Société française de pédiatrie Vol. 25; no. 2; p. 163
Main Authors: Vergier, J, Marquant, E, Busa, T, Reynaud, R
Format: Journal Article
Language:French
Published: France 01.02.2018
Subjects:
Adolescent
Algorithms
Child
Child, Preschool
Female
Gigantism - diagnosis
Gigantism - etiology
Growth Disorders - diagnosis
Growth Disorders - etiology
Humans
Male
Obesity
Wiedemann-Beckwith syndrome
Sotos syndrome
Acrogigantism
Early puberty
Hyperthyroidism
Familial tall stature
Marfan syndrome
ISSN:1769-664X, 1769-664X
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Summary:Tall stature is not a common motive for medical consultation, even though by definition 2.5 % of children in the general population are concerned. It is usually defined as height greater than+2 standard deviations (SD) using the appropriate growth chart for age and gender, or a difference greater than +2 SD between actual height and target height. With a patient presenting tall stature, the physician has to determine whether it is a benign feature or a disease. Indeed, making the diagnosis is essential for hormonal disease or genetic overgrowth syndromes. The past medical history including parents' height, prenatal and birth data, physical examination along with anthropometry (height, weight, head circumference, body mass index), and growth chart evaluation with the detailed growth pattern are generally sufficient to make the diagnosis such as familial tall stature, obesity, or early puberty. Bone age estimation may be helpful for some specific etiologies and is also necessary to help predict final adult height. After exclusion of common causes, further investigation is required. Sudden growth acceleration often reveals endocrine pathology such as early puberty, hyperthyroidism, or acrogigantism. Tall stature accompanied by dysmorphic features, congenital malformations, developmental delay, or a family medical history may be related to genetic disorders such as Marfan, Sotos, or Wiedemann-Beckwith syndromes. We relate here the most frequent etiologies of overgrowth syndromes.
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ISSN:1769-664X
1769-664X
DOI:10.1016/j.arcped.2017.12.010