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Marc is a 15- year-old boy with short stature and delayed sexual development (height 60 inches...

Marc is a 15- year-old boy with short stature and delayed sexual development (height 60 inches weight 110 pounds, Tanner stage II). Marc's younger brother, age 13, is taller and more developed than Marc. Evaluation for bone demonstrates an approximate of 12 years.

1. What are the potential causes of short stature in this case?

2. What further history, physical, and labratory data would be helpful in determining the cause?

3. Under wht condition might growth hormone replacement be indicated? What are the benefits and risks of this therapy?

4. Under what condition might testosterone be given? What are the benefits and risks of this therapy?

5. What does bone age of 12 years suggest about the potential for achieving further linear bone growth?

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Answer #1

The bone age of Marc is less than the chronological age .This can be caused by constitutional delay in growth and puberty. But his younger brother is taller and more developed than him,which rules out this possibility.

So this is most probably due to some endocrine cause like growth hormone deficiency ,hypothyroidism etc.

History about hypothyroidism features should be asked.Serum TSH,free T3 and free T4 levels should be checked for .GH suppression tets should be done.

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