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Long-term follow-up after bilateral percutaneous epiphysiodesis around the knee to reduce excessive predicted final height
  1. Peter C Hindmarsh
  1. Correspondence to Professor Peter C Hindmarsh, Department of Paediatrics, University College London Hospitals, London NW1 2BU, UK; p.hindmarsh{at}ucl.ac.uk

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Height is a useful measure of the health of the population and of the individual. Most acute and chronic childhood conditions impact on growth, and growth can be used as a marker of the success of therapeutic interventions. As a general principle, the further the individual goes away from the average for age, the more likely that there is an explanation for their stature. In terms of tall stature, the majority of individuals have constitutional tall stature, although disorders such as precocious puberty, hyperthyroidism and syndromes (Klinefelter or Marfan) need to be considered. Pituitary gigantism, due to excessive secretion of growth hormone, is rare. Box provides a more extensive listing of causes.

Box

Causes of an increased adult height

Constitutional tall stature

Endocrine

  • Hyperthyroidism.

  • Oestrogen receptor mutations and aromatase deficiency.

  • Pituitary gigantism due to growth hormone excess.

Obesity and overnutrition in the first 2 years of life

Syndromes

  • Marfan syndrome.

  • Sotos syndrome.

  • Klinefelter syndrome and XYY chromosomal abnormalities.

  • Beckwith-Wiedemann.

  • Weaver.

Metabolic

  • Homocystinuria.

Positive secular trends in stature due to improved general health and economic conditions of a nation have been documented over the past 200 years1 either in the short term (heights of Japanese boys between 1950 and 1960 peaked at an increment of 8 cm per decade at age 14 years) or long term (mean height of Dutch male army recruits increased from 165 cm in 1865 to 182 cm in 1980). As a …

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