Idiopathic short stature (ISS) is a diagnosis of exclusion. No specific laboratory test can identify it. Rather, a series of tests that examine a person’s genetic, nutritional and hormonal makeup are used to exclude specific diagnoses. However, abnormalities of the growth hormone-insulin-like growth factor (GH-IGF) axis appear to be common in children with ISS. As the only growth-promoting treatments available to children with ISS are either human GH or recombinant human IGF-I, it is plausible that measures of the GH-IGF axis or of growth factor response might be useful in predicting response to therapy or choosing the optimal medical regimen.

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