Etiology of short stature in children attending pediatric endocrinology clinic of a tertiary care hospital in Bangladesh


  • Muhammad Rezaul Karim Department of Pediatrics, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka, Bangladesh
  • Kohinoor Jahan Shamaly Department of Pediatrics, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka, Bangladesh
  • Baraka Badrudduja Tithi Department of Pediatrics, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka, Bangladesh
  • Romana Akter Department of Pediatrics, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka, Bangladesh
  • Ismat Jahan Department of Pediatrics, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka, Bangladesh
  • Suraiya Begum Department of Pediatrics, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka, Bangladesh



Etiology, Growth, Short stature


Background: Short stature is a common problem to practicing pediatricians. It results from various etiologies, which are categorized as normal variants and pathological causes. Normal variant short stature consists of Familial Short Stature (FSS) and Constitutional Growth Delay (CGD), while pathological causes are subdivided into endocrine diseases, clinically defined syndromes, chronic diseases, metabolic diseases and others. There are not so much data available in Bangladesh in this respect. So, present study was conducted to know the common causes of short stature.

Methods: This cross-sectional study was done in pediatric endocrinology clinic of Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from January 2017 to August 2018. One hundred children with short stature meeting inclusion criteria were recruited after taking an informed consent. The detailed history, physical examination including anthropometric measurements and relevant investigations were done. Data were recorded on a predesigned questionnaire for final analysis.

Results: The common causes of short stature identified were familial short stature (FSS) 51% cases, Constitutional Growth Delay (CGD) 14% cases and hypothyroidism 12% cases. Other less common causes of short stature were Growth Hormone Deficiency (GHD) 8% cases, malnutrition 6% cases and genetic syndrome 5% cases.

Conclusions: FSS and CGD were the leading cause of short stature in children. Endocrinological causes were the most common cause of short stature after normal variant while nonendocrine causes were the least.


Brande JL, Rappaport R. Normal and abnormal growth. In: Bertrand J, Rappaport R, Sizonenko PC, eds. Pediatric endocrinology, physiology, pathophysiology and clinical aspect. 2nd ed. Philadelphia, Williams and Wilkins; 1993:185-207.

Rogol AD. Causes of short stature. In: Rose BD, eds. Up-todate. Waltham MA: up to date; 2007. Available at: Accessed 29 June 2018.

Ranke MB. The Kabi Pharmacia International Growth Study: aetiology classification list with comments. Acta Pediatr. 1991;80:87-92.

Ranke MB, Grauer ML, Kistner K, Blum WF, Wollmann HA. Spontaneous adult height in idiopathic short stature. Hormone Res Paediatr. 1995;44(4):152-7.

Han JC, Balagopal P, Sweeten S, Darmaun D, Mauras N. Evidence for hypermetabolism in boys with constitutional delay of growth and maturation. J Clin Endocrinol Metabol. 2006;91(6):2081-6.

Du Caju MV, De Beeck LO, Sys SU, Hagendorens MM, Rooman RP. Progressive deceleration in growth as an early sign of delayed puberty in boys. Hormone Res Paediatr. 2000;54(3):126-30.

Bhadada SK, Bhansali A, Ravi Kumar P, Kochhar R, Nain CK, Dutta P, Lal S. Changing scenario in aetiological profile of short stature in India-growing importance of celiac disease: a study from tertiary care centre. Ind J Pediatr. 2011;78(1):41-4.

Van Rijn JC, Grote FK, Oostdijk W, Wit JM. Short stature and the probability of coeliac disease, in the absence of gastrointestinal symptoms. Archiv Disease Childhood. 2004;89(9):882-3.

Waheed KA, Irfan K, Ahmed TM, Khan HI. Spectrum of clinical presentation of chronic renal failure in children. Pak Paediatr J. 2002;26:167-71.

Queiroz MS, Nery M, Cancado EL, Gianella-Neto D, Liberman B. Prevalence of celiac disease in Brazilian children of short stature. Brazilian J Med Biol Res. 2004;37(1):55-60.

Famuyiwa OO. Short stature at the University College Hospital, Ibadan, Nigeria. West African J Med. 1992;11(1):62-71.

Abuzzahab MJ, Schneider A, Goddard A, Grigorescu F, Lautier C, Keller E, et al. IGF-I receptor mutations resulting in intrauterine and postnatal growth retardation. New Engl J Med. 2003;349(23):2211-22.

Lam WF, Hau WL, Lam TS. Evaluation of referrals for genetic investigation of short stature in Hong Kong. Chinese Med J. 2002;115(4):607-11.

Parks JS, Felner EI. Hypopituitarism. In: Kliegman RM, Stanton BF, St. Geme JW, Schor NF, Behrman RE, eds. Nelson Textbook of Pediatr. 20th ed. Philadelphia: Saunders; 2016:2643.

Miller BS, Zimmerman D. Idiopathic short stature in children. Pediatr Ann. 2004;33:177-81.

Hussen A, Farghaly H, Askar E, Metwalley K, Saad K, Zahran A, et al. Etiological factors of short stature in children and adolescents: experience at a tertiary care hospital in Egypt. Ther Adv Endocrinol Metab. 2017;8(5):75-80.

Rabbani MW, Khan WI, Afzal AB, Rabbani W. Causes of short stature identified in children presenting at a tertiary care hospital in Multan Pakistan. Pak J Med Sci. 2013;29(1):53.

Ullah F, Ghaffar T, Afridi AK, Ali A, ul hasan Aamir A. Short stature: what is the cause in our population. J Ayub Med Coll Abbottabad. 2016;28(1):135-40.

Lashari SK, Korejo HB, Memon YM. To determine frequency of etiological factors in short statured patients presenting at an endocrine clinic of a tertiary care hospital. Pak J Med Sci. 2014;30(4):858.

Moayeri H, Aghighi Y. A prospective study of etiology of short stature in 426 short children and adolescents. Age. 2004;14(1.7):13-3.

Sultan M, Afzal M, Qureshi SM, Aziz S, Lutfullah M, Khan SA, et al. Etiology of short stature in children. J Coll Physicians Surg Pak. 2008;18(8):493-7.

Shiva S, Nikzad A. Etiology of short stature in east Azerbaijan, Iran. Iran J Pediatr. 2009;19(1):35-9.

Mohamed SH, Al Otaibi HM, Al Issa ST, Omer HG. Short stature in children: Pattern and frequency in a pediatric clinic, Riyadh, Saudi Arabia. Sudanese J Paediatr. 2012;12(1):79.

Shu SG, Chen YD, Chi CS. Clinical evaluation of short children referred by school screening: an analysis of 655 children. Acta Paediatr. 2002;43(6):340-4.

Gjikopulli A, Grimci L, Kollcaku L, Cullufi P, Tako A. Pattern and Frequency of Short Stature in Albanian Children. Curr Health Sci J. 2016;42(4):390.

Lindsay R, Feldkamp M, Harris D, Robertson J, Rallison M. Utah Growth Study: growth standards and the prevalence of growth hormone deficiency. J Pediatr. 1994;125(1):29-35.






Original Research Articles