Clinical evaluation of short children referred by school screening: an analysis of 655 children.

A national screening and referral program of short school children was launched in Taiwan in 2000. We analyzed 655 referrals (boys 303, girls 352) from this program whose heights were below--2 standard deviation score (SDS) for age and gender. Evaluation included: detailed medical history, physical examination and laboratory tests such as blood count, thyroid function, growth hormone screening, bone age and chromosome tests. The results were compared with worldwide data. Normal variations accounted for 64.9% of all etiologies for reasons such as constitutional delay 37.4%, familial short stature 16.5%, and a combination of above two 11.0%. The rest were of pathological short stature for reasons such as: idiopathic short stature 7.9%, growth hormone deficiency 7.9%, precocity 3.2%, skeletal dysplasia 2.3%, intrauterine growth retardation 1.4%, Turner syndrome 1.4%, other chromosomal anomaly 0.8%, and others 5.0%. We conclude that the majority of short stature in Taiwanese children is due to normal variation although potentially treatable causes account for at least 12.8% of cases, such as GHD, Turner syndrome, hypothyroidism and precocity. The inexpensive screening program therefore seems to be beneficial in identifying children with short stature of potentially treatable etiology.