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Review
. 2019;15(1):10-21.
doi: 10.2174/1573396314666181105092917.

Tall Stature: A Challenge for Clinicians

Beatriz Corredor  1 , Mehul Dattani  1   2 , Chiara Gertosio  3 , Mauro Bozzola  3   4
Affiliations
Review

Tall Stature: A Challenge for Clinicians

Beatriz Corredor et al. Curr Pediatr Rev. 2019.

Abstract

Clinicians generally use the term "tall stature" to define a height more than two standard deviations above the mean for age and sex. In most cases, these subjects present with familial tall stature or a constitutional advance of growth which is diagnosed by excluding the other conditions associated with overgrowth. Nevertheless, it is necessary to be able to identify situations in which tall stature or an accelerated growth rate indicate an underlying disorder. A careful physical evaluation allows the classification of tall patients into two groups: those with a normal appearance and those with an abnormal appearance including disproportion or dysmorphism. In the first case, the growth rate has to be evaluated and, if it is normal for age and sex, the subjects may be considered as having familial tall stature or constitutional advance of growth or they may be obese, while if the growth rate is increased, pubertal status and thyroid function should be evaluated. In turn, tall subjects having an abnormal appearance can be divided into proportionate and disproportionate syndromic patients. Before initiating further investigations, the clinician needs to perform both a careful physical examination and growth evaluation. To exclude pathological conditions, the cause of tall stature needs to be considered, although most children are healthy and generally do not require treatment to inhibit growth progression. In particular cases, familial tall stature subject can be treated by inducing puberty early and leading to a complete fusion of the epiphyses, so final height is reached. This review aims to provide proposals about the management of tall children.

Keywords: Tall stature; challenge; clinicians; disproportionate syndromes; proportionate syndromes; puberty..

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Figures

Fig. (1)
Fig. (1)
Diagnostic approach to tall children. SD: Standard Deviations, MPH: Midparental Height, IBM: Body Mass Index, CAH: Congenital Adrenal Hyperplasia, GH: Growth Hormone, CAG: Constitutional Advance of Growth.
Fig. (2)
Fig. (2)
Genetic of pituitary adenomas (from Marques P. et al, 2017) [18].
Fig. (3)
Fig. (3)
Tall stature treatment schedule.
See this image and copyright information in PMC

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