Genetic evaluation in children with short stature

Abstract

Purpose of review: Short stature is a common clinical manifestation in children. Yet, a cause is often unidentifiable in the majority of children with short stature by a routine screening approach. The purpose of this review is to describe the optimal genetic approach for evaluating short stature, challenges of genetic testing, and recent advances in genetic testing for short stature.

Recent findings: Genetic testing, such as karyotype, chromosomal microarray, targeted gene sequencing, or exome sequencing, has served to identify the underlying genetic causes of short stature. When determining which short stature patient would benefit from genetic evaluation, it is important to consider whether the patient would have a single identifiable genetic cause. Specific diagnoses permit clinicians to predict responses to growth hormone treatment, to understand the phenotypic spectrum, and to understand any associated co-morbidities.

Summary: The continued progress in the field of genetics and enhanced capabilities provided by genetic testing methods expands the ability of physicians to evaluate children with short stature for underlying genetic defects. Continued effort is needed to elaborate new genetic causes of linear growth disorders, therefore, we expand the list of known genes for short stature, which will subsequently increase the rate of genetic diagnosis for children with short stature.

Figure 1.. Considerations for genetic testing based on parental heights.

ISS, idiopathic short stature; SDS, standard deviation score; TFT, thyroid function test; LFT, liver function test; PAH, predicted parental height; MPH, mid-parental height; FSS, familial short stature; CDGP, constitutional delay of growth and puberty.

Figure 2.. Clinical clues that may indicate a certain genetic cause.

The listed genes and syndromes are the examples. ISS, idiopathic short stature; SDS, standard deviation score; TFT, thyroid function test; LFT, liver function test.