Clinical Case (2)


Sara is a 5 year old girl brought to Pediatric clinic by her parents who were worried about her growth. The mother noted that Sara’s shoes size did not change for 1.5 year and she is still in clothes for 2 to 3 years old girls

She was born at 38 weeks by normal vaginal delivery. Her birth weight was 2.250 Kg – at 10th centile. The mother mentioned that she had edema on the dorsum of her feet and hand at birth and it persisted for one month then disappeared.  Now, she is generally well apart from recurrent ear infections

On examination, she is healthy and well nourished. There were wide spaced nipples and low hairline but no other abnormalities could be found. Her height was 86 cm (below 3rd centile. Her mother’s height was 154 cm while her father’s height was 172 cm

CBC, serum calcium, liver function tests, serum creatinine, thyroid profile, and celiac screening all were normal. Echocardiography and abdominal ultrasonography were normal


Answer the following questions

  • Calculate the mid-parental height for this girl
  • Based on the above clinical data, what is the most probable diagnosis for this girl short stature
  • How to confirm this diagnosis? (one investigation

If this diagnosis was confirmed, what is the treatment that should be given to her at this age