Short Stature – the Tip of the Iceberg of a Serious Illnesses – a Case Report

Abstract

Objective − The aim of this paper was to emphasize the importance of a complete physical examination of a child referred to a pediatric endocrinologist due to short stature. Although short stature is usually considered to be a sign of an endocrinological disease, a broad spectrum of other pediatric disorders may be the cause of growth retardation.

Case Report − A 9-year-old girl was referred to a pediatric endocrinologist due to short stature. Physical examination revealed her height to be 120 cm (-2.7 SD) and her weight to be 17.75 kg (-3.93 SD). In addition, she looked extremely pale and had tachycardia (130 bpm). Laboratory tests revealed severe microcytic anemia. A wide diagnostic work-up was performed, without revealing a clear cause of the disease. It was found out that the girl had never started eating solid food and that her diet was extremely limited. Psychological and psychiatric evaluation were done. She received 7 doses of iron sucrose in total. During her hospital stay she was fed with enteral formulas, and food intake was gradually increased with the introduction of solid foods. Complete laboratory recovery from anemia was achieved within 2 months. In parallel with nutritional replenishment, her height and weight improved.

Conclusion − This case demonstrates the importance of a thorough physical examination and preventive routine periodic evaluation in order to prevent further health impairment and possible life-threatening complications.