Investigation and Management of Abnormal Growth

Abstract

As a general principle, all chronic paediatric diseases may cause stunting of growth. By and large if a child’s poor growth is due to a general system disease, such as chronic renal failure, the primary condition will have already produced symptoms that outweigh the growth problems. These disorders therefore tend to present not because of short stature but because of some other anxiety. This is, however, not an absolute rule. There are one or two notorious exceptions to which the clinician must be alert. Probably the most important, in terms of frequency with which it occurs, is coeliac syndrome, which quite commonly presents because of short stature with no overt gastro-intestinal symptoms¹. Indeed the gastro-intestinal system is a particular trap as Crohn’s disease may present with short stature and particularly delayed puberty.