Current Concepts in Tall Stature and Overgrowth Syndromes
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S.L.S. Drop
,
N. Greggio
Abstract
In this overview an update is given on the pathogenesis, classification and differential diagnosis of overgrowth syndromes. In addition, height prognosis and therapeutic modalities available for managing mainly constitutional tall stature are discussed. Constitutional tall stature comprises normal variants in which one or both parents are tall. Primary disorders may have a prenatal onset and may be of chromosomal or genetic origin. Secondary overgrowth syndromes are most often the result of hormonal disturbances. Height prediction plays a key role in the management of tall children. Prediction equation models have been developed based on the growth data of healthy tall children. There is general agreement that a favourable effect on reducing ultimate height is obtained using high doses of sex steroids (girls 100-300 μg ethinyl- oestradiol; boys testosterone (T) ester depot preparations 250-1000 mg/month), the height reduction being greater when the treatment is started at a lower chronological and/or bone age. An alternative is the induction of puberty with low doses of sex steroids (girls 5-50 μg ethinyloestradiol; boys T esters 25-50 mg/m2/3 wk). In addition orthopaedic procedures have been suggested, but there is limited experience. Although psychosocial factors constitute the main reason for treating tall stature, extensive psychological investigations before or during height limiting therapy are lacking. Moreover, there are no objective data indicating lifelong psychosocial damage resulting from being tall.
© 2016 by Walter de Gruyter Berlin/Boston
Articles in the same Issue
- Titelei
- Table of Contents
- Introduction
- Opening Remarks
- Factors Determining Final Height in Congenital Adrenal Hyperplasia
- Management of Puberty for Optimal Auxological Results in β-Thalassaemia Major
- Unresolved Problems Concerning Optimal Therapy of Puberty in Children with Chronic Renal Diseases
- Management of Puberty in Constitutional Delay of Growth and Puberty
- Turner’s Syndrome
- Idiopathic Short Stature
- Current Concepts in Tall Stature and Overgrowth Syndromes
- Optimal Therapy of Pubertal Disorders in Precocious/Early Puberty
- Unresolved Problems in Optimal Therapy of Pubertal Disorders in Oncological and Bone Marrow Transplanted Patients
- Isolated Growth Hormone Deficiency in Children and Adolescents
- Multiple Pituitary Hormone Deficiency: Management of Puberty for Optimal Auxological Results
- Concluding Remarks
Articles in the same Issue
- Titelei
- Table of Contents
- Introduction
- Opening Remarks
- Factors Determining Final Height in Congenital Adrenal Hyperplasia
- Management of Puberty for Optimal Auxological Results in β-Thalassaemia Major
- Unresolved Problems Concerning Optimal Therapy of Puberty in Children with Chronic Renal Diseases
- Management of Puberty in Constitutional Delay of Growth and Puberty
- Turner’s Syndrome
- Idiopathic Short Stature
- Current Concepts in Tall Stature and Overgrowth Syndromes
- Optimal Therapy of Pubertal Disorders in Precocious/Early Puberty
- Unresolved Problems in Optimal Therapy of Pubertal Disorders in Oncological and Bone Marrow Transplanted Patients
- Isolated Growth Hormone Deficiency in Children and Adolescents
- Multiple Pituitary Hormone Deficiency: Management of Puberty for Optimal Auxological Results
- Concluding Remarks
