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REVIEW ARTICLE
Year : 2012  |  Volume : 16  |  Issue : 5  |  Page : 698-705

An approach to constitutional delay of growth and puberty


1 Department of Pediatrics, Division of Endocrinology, Hamad General Hospital, Doha, Qatar
2 Pediatric and Adolescent Outpatient Clinic, Quisisana Hospital, Ferrara, Italy

Correspondence Address:
Ashraf T Soliman
Department of Pediatrics, Division of Endocrinology, Hamad General Hospital, P O Box 3050, Doha
Qatar
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2230-8210.100650

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Constitutional delay of growth and puberty is a transient state of hypogonadotropic hypogonadism associated with prolongation of childhood phase of growth, delayed skeletal maturation, delayed and attenuated pubertal growth spurt, and relatively low insulin-like growth factor-1 secretion. In a considerable number of cases, the final adult height (Ht) does not reach the mid-parental or the predicted adult Ht for the individual, with some degree of disproportionately short trunk. In the pre-pubertal male, testosterone (T) replacement therapy can be used to induce pubertal development, accelerate growth and relieve the psychosocial complaints of the adolescents. However, some issues in the management are still unresolved. These include type, optimal timing, dose and duration of sex steroid treatment and the possible use of adjunctive or alternate therapy including: oxandrolone, aromatase inhibitors and human growth hormone.


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