{"id":25314,"date":"2025-09-10T15:35:07","date_gmt":"2025-09-10T14:35:07","guid":{"rendered":"https:\/\/apps.nhslothian.scot\/refhelp\/?page_id=25314"},"modified":"2026-05-28T13:13:31","modified_gmt":"2026-05-28T12:13:31","slug":"short-stature","status":"publish","type":"page","link":"https:\/\/apps.nhslothian.scot\/refhelp\/short-stature\/","title":{"rendered":"Short stature"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\">The potential causes of short stature in children are broad ranging, and therefore a careful history and examination are essential to narrow down the possibilities.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Possible causes include:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Genetic short stature<\/li>\n\n\n\n<li>Constitutional delay in growth and puberty<\/li>\n\n\n\n<li>Dysmorphic syndromes<\/li>\n\n\n\n<li>Endocrine disorders<\/li>\n\n\n\n<li>Chronic diseases<\/li>\n\n\n\n<li>Psychosocial deprivation.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">An endocrinopathy is more likely when there is evidence, or suspicion, of multiple pituitary hormone abnormalities or of an intra-cranial lesion. Relevant neonatal history may include hypoglycaemia or microphallus.<br><br><strong>Initial assessment should include:<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Detailed history, including determination of <em>when<\/em> the child\u2019s growth started to falter.<\/li>\n\n\n\n<li>Careful family history, measurements of both parents and determination of the mid-parental centile, see  <a href=\"https:\/\/www.rcpch.ac.uk\/resources\/growth-charts\" target=\"_blank\" rel=\"noreferrer noopener\">RCPCH Growth Charts<\/a> .<\/li>\n\n\n\n<li>Examination should include pubertal staging if age-appropriate, and description of any dysmorphic features or body disproportion.<\/li>\n<\/ul>\n\n\n\n<div class=\"wp-block-getwid-tabs\" data-active-tab=\"0\"><ul class=\"wp-block-getwid-tabs__nav-links\"><\/ul>\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Referral Guidelines<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<h4 class=\"wp-block-heading\">Who to refer:<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Severe short stature = height below the 0.4th centile<\/li>\n\n\n\n<li>Height more than 2 centile spaces below the mid-parental height<\/li>\n\n\n\n<li>Downwards crossing of more than 1 height centile in 1 year, in a child aged 2 years or over<\/li>\n\n\n\n<li>Children who may be candidates for growth hormone therapy due to one of the following indications:\n<ul class=\"wp-block-list\">\n<li>small for gestational age without catch-up by age 4 yrs<\/li>\n\n\n\n<li>chronic renal disease and short stature<\/li>\n\n\n\n<li>syndromic causes of short stature including Turner\u2019s syndrome.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Please include child\u2019s current weight and height, and parents\u2019 heights if possible. We can plot these on Trak to determine severity and appropriate timing of review.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">If blood investigations are undertaken prior to referral, please consider: FBC, U&amp;Es, LFTs, TFTs, iron studies, vitamin D, coeliac screen, IGF1.&nbsp; Gonadotrophins, oestradiol, testosterone and karyotype may be appropriate depending on the child\u2019s age and the clinical situation. We are happy to perform these tests when children are seen in clinic.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">Who not to refer:<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Children who do not fulfil the clinical criteria listed above. Most commonly these are children whose height is within the mid-parental centile spread. Occasionally this may be due to a relevant inherited cause of short stature, and these children can be discussed with medical paediatrics. This can be done by submitting a referral as below, asking for advice only or advice \/ review.<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\">How to refer:<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">Edinburgh, East &amp; Mid Lothian: Refer via Sci-Gateway (Royal Hospital for Children and Young People&nbsp;&gt; General Medicine &gt; LI Basic Sign Referral)&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">West Lothian: Refer via Sci-Gateway (St John\u2019s Hospital&nbsp;&gt; Paediatrics &gt; LI Basic Sign Referral)&nbsp;<\/p>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Primary Care Management<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<p class=\"wp-block-paragraph\"><\/p>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Resources and Links<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<p class=\"wp-block-paragraph\">The Scottish Paediatric Endocrine Group has a national guideline for Short Stature, which can be accessed via this link:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/www.nn.nhs.scot\/speg\/for-professionals\/speg-guidelines\/\" target=\"_blank\" rel=\"noreferrer noopener\">SPEG Guidelines \u2013 Scottish Paediatric Endocrine Group<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The RCPCH growth charts contain guidance on determining the mid parental target centile, and spread: <a href=\"https:\/\/www.rcpch.ac.uk\/resources\/growth-charts\" target=\"_blank\" rel=\"noreferrer noopener\">RCPCH Growth Charts<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">NICE indications for growth hormone replacement:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/www.nice.org.uk\/guidance\/ta188\/chapter\/1-Recommendations\" target=\"_blank\" rel=\"noreferrer noopener\">1 Recommendations | Human growth hormone (somatropin) for the treatment of growth failure in children | Guidance | NICE<\/a><\/p>\n<\/div><\/div>\n<\/div>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n","protected":false},"excerpt":{"rendered":"<p>The potential causes of short stature in children are broad ranging, and therefore a careful history and examination are essential to narrow down the possibilities. Possible causes include: An endocrinopathy is more likely when there is evidence, or suspicion, of multiple pituitary hormone abnormalities or of an intra-cranial lesion. Relevant neonatal history may include hypoglycaemia<\/p>\n","protected":false},"author":6,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_searchwp_excluded":"","footnotes":""},"categories":[],"class_list":["post-25314","page","type-page","status-publish","hentry"],"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"rttpg_featured_image_url":null,"rttpg_author":{"display_name":"heatherlevy","author_link":"https:\/\/apps.nhslothian.scot\/refhelp\/author\/heatherlevy\/"},"rttpg_comment":0,"rttpg_category":false,"rttpg_excerpt":"The potential causes of short stature in children are broad ranging, and therefore a careful history and examination are essential to narrow down the possibilities. Possible causes include: An endocrinopathy is more likely when there is evidence, or suspicion, of multiple pituitary hormone abnormalities or of an intra-cranial lesion. Relevant neonatal history may include hypoglycaemia","_links":{"self":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/25314","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/users\/6"}],"replies":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/comments?post=25314"}],"version-history":[{"count":3,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/25314\/revisions"}],"predecessor-version":[{"id":28093,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/25314\/revisions\/28093"}],"wp:attachment":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/media?parent=25314"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/categories?post=25314"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}