What are possible consequences of overlooking or delaying the detection of an underlying disease that causes short stature or poor growth?

Many diseases (including infectious, gastrointestinal, kidney, heart and hormonal) can present with growth failure months or years before other symptoms develop, so overlooking growth failure as a clinical clue can lead to delayed diagnosis and treatment. This may adversely affect outcome not only for height, but also for the underlying disease and the child’s overall health. For example, long-standing unrecognized and untreated celiac disease, an intolerance to proteins found in wheat, predisposes development of other autoimmune conditions.

Delayed treatment adversely affects height outcome because growth cannot be further improved once the growth plates fuse at the end of puberty. Sometimes doctors will try to medically delay puberty to allow more time for growth, but there are psychosocial and bone health costs to delaying puberty for years beyond normal. Thus, whether it’s a disease whose improvement leads to catch-up growth or a condition requiring growth hormone therapy, the ... more.

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