My son is 11 years, weight 33 kg, height 134 cm, father's height 165 cm, mother's height 155 cm. The increment in height in the last 2 years was 4 cm/year. Does he need growth hormone therapy? What are the investigations needed?
Your son's height falls just below the 10th percentile of height for age (WHO standard).
Given that your height (parents' height) is in low to mid normal range compared to the average height of the population at large, your son's height is not lagging behind that far.
His height gain in the previous two years is on the lower side. However, his main height gain will be in the forthcoming years when he enters puberty.
So at this stage, growth hormone therapy is not warranted, unless a recent head injury or a recently developed pituitary gland tumor has put his growth and development at risk.
If he does not have a headache, decreased field of vision or seizure disorder or take steroids for any other illness or have kidney or liver disorder, he can be just observed over the next three to six months.
Maybe you can assess his nutrition intake, activity level and check his serum IGF-1 (Insulin-like Growth Factor-1), serum bilirubin, SGOT, SGPT, serum protein and albumin, hemoglobin, serum creatinine, free T4, TSH and inform me the reports (just to rule out any major disorder).
.. gone through all your reports (attachment removed to protect patient identity) and your current prescription.
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