Background: Despite clarification of the term idiopathic short stature (ISS) provided by an international consensus group, several points of discussion remain. Methods and Results: Various cut-off limits can be used for the definition of ‘short’, and in the absence of recent population-based references, decisions have to be taken about which reference to use, whether corrections for secular trend have to be made, and which references should be used for ethnic minorities. For the definition of ‘idiopathic’, decisions have to be taken regarding which disorders should be excluded and by which tools; how to deal with the fluid border between ISS and persistent short stature after being born small for gestational age; and which limit of disproportion is acceptable. Conclusions: Distinguishing between the two subclasses of ISS, familial short stature (FSS) versus non-familial short stature (non-FSS), requires a decision as to which of the various formulas for the parent-specific lower limit of height standard deviation score should be used, particularly when comparing final height with prepubertal height, predicted adult height, and target height. The distinction between FSS and non-FSS is also important for evaluating spontaneous growth in children with ISS.

1.
Ranke MB: Towards a consensus on the definition of idiopathic short stature. Summary. Horm Res 1996;45(suppl 2):64–66.
2.
Pawlowski B, Dunbar RI, Lipowicz A: Tall men have more reproductive success. Nature 2000;403:156.
3.
Fredriks AM, Van Buuren S, Burgmeijer RJF, Meulmeester JF, Beuker RJ, Brugman E, Roede MJ, Verloove-Vanhorick SP, Wit JM: Continuing positive secular growth change in The Netherlands 1955–1997. Pediatr Res 2000;47:316–323.
4.
Bodzsar EB, Suzanne C: Secular growth changes in Europe. 1998. Budapest, Eotvos University Press.
5.
Hermanussen M, Burmeister J: Synthetic growth reference charts. Acta Paediatr 1999;88:809–814.
6.
Fredriks AM, Van Buuren S, Jeurissen SE, Dekker FW, Verloove-Vanhorick SP, Wit JM: Height, weight, body mass index and pubertal development reference values for children of Turkish origin in the Netherlands. Eur J Pediatr 2003;162:788–793.
7.
Fredriks AM, Van Buuren S, Jeurissen SE, Dekker FW, Verloove-Vanhorick SP, Wit JM: Height, weight, body mass index and pubertal development references for children of Moroccan origin in The Netherlands. Acta Paediatr 2004;93:817–824.
8.
WHO. Global Database on Child Growth and Malnutrition. 2006. www.who.int/nutgrowthdb/en.
9.
Van Buuren S, Van Dommelen P, Zandwijken GR, Grote FK, Wit JM, Verkerk PH: Towards evidence based referral criteria for growth monitoring. Arch Dis Child 2004;89:336–341.
10.
Grote FK, Oostdijk W, De Muinck Keizer-Schrama SM, Dekker FW, Verkerk PH, Wit JM: Growth monitoring and diagnostic work-up of short stature: an international inventorization. J Pediatr Endocrinol Metab 2005;18:1031–1038.
11.
Wit JM: Growth hormone treatment of idiopathic short stature in KIGS; in Ranke MB, Wilton P (eds): Growth Hormone Therapy – 10 Years’ Experience. Heidelberg, Johann Ambrosius Barth Verlag, 1999, pp 225–243.
12.
Wit JM, Finken MJ, Rijken M, Walenkamp MJ, Oostdijk W, Veen S: Confusion around the definition of small for gestational age. Pediatr Endocrinol Rev 2005;3:52–53.
13.
Wit JM, Finken MJ, Rijken M, de Zegher F: Preterm growth restraint: a paradigm that unifies intrauterine growth retardation and preterm extrauterine growth retardation, and has implications for the small-for-gestational-age indication in growth hormone therapy. Pediatrics 2006;117:e793–e795.
14.
Yun DJ, Yun DK, Chang YY, Lim SW, Lee MK, Kim SY: Correlations among height, leg length and arm span in growing Korean children. Ann Hum Biol 1995;22:443–458.
15.
Fredriks AM, Van Buuren S, van Heel WJ, Dijkman-Neerincx RH, Verloove-Vanhorick SP, Wit JM: Nationwide age references for sitting height, leg length, and sitting height/height ratio, and their diagnostic value for disproportionate growth disorders. Arch Dis Child 2005;90:807–812.
16.
van Rijn JC, Grote FK, Oostdijk W, Wit JM: Short stature and the probability of coeliac disease, in the absence of gastrointestinal symptoms. Arch Dis Child 2004;89:882–883.
17.
De Muinck Keizer-Schrama SM: [Consensus ‘diagnosis of short stature in children’. National Organization for Quality Assurance in Hospitals]. Ned Tijdschr Geneeskd 1998;142:2519–2525.
18.
Hermanussen M, Cole J: The calculation of target height reconsidered. Horm Res 2003;59:180–183.
19.
Niewenweg R, Smit ML, Walenkamp MJ, Wit JM: Adult height corrected for shrinking and secular trend. Ann Hum Biol 2003;30:563–569.
20.
Mul D, Fredriks AM, Van Buuren S, Oostdijk W, Verloove-Vanhorick SP, Wit JM: Pubertal development in The Netherlands 1965–1997. Pediatr Res 2001;50:479–486.
21.
Wit JM, Kamp GA, Rikken B: Spontaneous growth and response to growth hormone treatment in children with growth hormone deficiency and idiopathic short stature. Pediatr Res 1996;39:295–302.
22.
Rekers-Mombarg LTM, Wit JM, Massa GG, Ranke MB, Buckler JMH, Butenandt O, Chaussain JL, Frisch H, Leiberman E: Spontaneous growth in idiopathic short stature. Arch Dis Child 1996;75:175–180.
23.
Rekers-Mombarg LT, Cole TJ, Massa GG, Wit JM: Longitudinal analysis of growth in children with idiopathic short stature. Ann Hum Biol 1997;24:569–583.
24.
Wit JM, Rekers-Mombarg LT: Final height gain by GH therapy in children with idiopathic short stature is dose dependent. J Clin Endocrinol Metab 2002;87:604–611.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.