Not all short kids need screening: new study

Short stature is not a reliable indicator for other diseases in children, according to a new study.
Short stature is not a reliable indicator for other diseases in children, according to a new study.

Kids who are short for their age but otherwise healthy probably don’t need extensive blood tests to determine if a disease is stunting their growth, researchers said in a new study.

Of 235 short kids without symptoms who were referred for specialty testing, just three had a possible diagnosis picked up on those labs, and only one diagnosis — for celiac disease — was confirmed, researchers found.

“Most of the screening tests are for diseases you really wouldn’t want to miss, but it’s rare that any of those diseases [would only] present with short stature,” said by Dr. Stephanie Sisley, who led the study.

Guidelines on short stature from endocrinology groups recommend lab screening for very short children, including those who don’t have any problems picked up on a physical exam. That screening includes blood tests for thyroid and growth hormones as well as calcium and other nutrients.

But one of the authors of those guidelines agreed that based on the new findings, kids who are short but have no other symptoms probably don’t need extensive screening.

Sisley and her colleagues reviewed the medical charts of 1,373 short children who were referred to the endocrinology clinic at Cincinnati Children’s Hospital Medical Center between 2008 and 2011. Of them, 235 were below the third percentile for height and had a normal check-up and no record of having stopped growing.

A 10-year-old girl who is 4 feet, 1 inch tall would fall just below the third percentile, for example, as would a 6-year-old boy who is 3 feet, 5 inches.

Few of those children underwent all tests recommended by the guidelines; the average kid had about two-thirds of them. One was diagnosed with celiac disease — when the body can’t process certain grains — and two others had signs of underlying conditions but didn’t finish follow-up tests.

There were 10 false positive lab results that didn’t pan out on further testing.

Altogether, the tests cost $315,321 — or $105,107 per possible diagnosis, the study team reported in The Journal of Pediatrics.

Sisley and her colleagues said their findings show many children are inappropriately referred to specialists for short stature. Rather than looking at a child’s height at one point, it’s more important to track it over time to see if a kid has stopped growing, they wrote.

“Any patient who really isn’t growing should be checked out,” Sisley, now at Baylor College of Medicine in Houston, told Reuters Health.

Dr. Alan Rogol, a professor emeritus at the University of Virginia in Charlottesville, agreed the new findings only apply to those kids who are short but have no record of growth delay.

The kids in this study “had nothing that pointed to difficulty in any system, and many of them were short kids of shorter parents,” Rogol, who reviewed the study for the journal, told Reuters Health.

He and Sisley both said those kids should be followed by their pediatrician for at least six months, then referred to a specialist if they really aren’t growing, or any time new symptoms show up.

“In this idealized set of kids, the things that pediatricians do best … are probably more worthwhile than sending them over to see an endocrinologist or somebody else,” Rogol said.

“I think parents are most worried that they’re missing something in the kid. It’s actually OK to follow the growth of a patient for six months or 12 months to see if something’s going on before you do specialized testing,” Sisley said.

“Much of the time, if their child is otherwise healthy … the bottom line is they’re probably going to be fine in the long run.”


News
Entertainment
Sports
Lifestyle
National

Florida man charged with murdering son to play…

A Florida man annoyed that his 16-month-old crying son was preventing him from playing video games suffocated the toddler, police said on Friday.

International

Powerful 7.2 magnitude earthquake rattles Mexico

A powerful earthquake struck Mexico Friday, shaking buildings and sending people running into the street, although there were no reports of major damage.

News

OMG! Exercise can make skin (and butt) look…

A moderate exercise regime can turn back time and actually reverse the skin's aging process, according to new research. The study showed that a minimum…

International

Jews in eastern Ukraine ordered to register, Kerry…

Secretary of State John Kerry condemned reports that Jews in eastern Ukraine had been ordered to register with the authorities "or suffer the consequences."

Entertainment

Whoopi Goldberg makes her debut as marijuana columnist

"It helps my head stop hurting, and with glaucoma your eyes ache, and she takes the ache out. It's wonderful," she said.

The Word

Kate Middleton made fun of Prince William's bald…

Kate Middleton and Prince William are in Sydney, Australia, right now, and it sounds like that brash Aussie sense of humor might be rubbing off.

The Word

Is Tom Cruise dating Laura Prepon?

"Mission: Impossible" star Cruise is said to be dating Laura Prepon, star of "Orange is the New Black."

Television

'Scandal' recap: Season 3, Episode 18, 'The Price…

Sally is Jesus, Olivia caused global warming, and Mellie's still drunk. Let's recap the Scandal finale. A church full of Washington insiders is about to…

NBA

Deron Williams leads Nets over Raptors in Game…

The Nets traveled to a raucous Air Canada Centre but came out with an important Game 1 victory over the Raptors.

NBA

Carmelo Anthony agonizing over Knicks future as season…

There’s still the cloud hanging over the franchise’s head as to the pending free-agent status of All-Star forward Carmelo Anthony.

NFL

Jets host players with eye toward NFL Draft

The Jets hosted a number of NFL Draft hopefuls for workouts on Thursday, with an eye toward some under-the-radar players.

NFL

Chris Johnson: I wanted to go to 'a…

Now that Chris Johnson is a Jet, the team has to figure out if one of the most explosive players in the NFL over the last half decade has anything…

Parenting

How to parent without gender stereotypes in a…

Christia Spears Brown, Phd. author of "Parenting beyond Pink & Blue" gives advice on raising kids free of gender stereotypes.

Tech

VIDEO: 'Vein-scanning' may become the future of paying

Designed to make transactions quicker and easier, the technology works by scanning the unique vein patterns in each person's palm.

Tech

#FollowFriday: 10 of the smartest Twitter accounts

Spending lots of time on Twitter? You might as well learn something. Here are some of the smartest accounts to follow.

Style

Light-up nail art syncs with phone

This Japanese technology syncs light-up nail art with your phone.