P TALL STATURE

Table 1

Laboratory tests and diagnostic imaging studies helpful in the evaluation of a child with tall stature

Adapted from Leung AK. Tall stature. In: Leung AK, ed. Common Problems in Ambulatory Pediatrics: Symptoms and Signs. New York: Nova Science Publishers, Inc, 2011, p. 309, with permission.

Suspected diagnosis	Suggested tests
Precocious puberty	Serum FSH, LH, estradiol, testosterone, DHEA, DHEAS, androstenedione,17α-hydroxyprogesterone, human chorionic gonadotropin; gonadotropin response to gonadotropin-releasing hormone; MRI of the sella
Ovarian or adrenal tumor	Serum estradiol, testosterone, DHEAS, androstenedione; abdominal ultrasonography or CT
Congenital adrenal hyperplasia	Serum electrolytes; serum testosterone, DHEAS, androstenedione, testosterone, 17α-hydroxyprogesterone, 11-deoxycortisol; ACTH
Pituitary growth hormone excess	Serum IGF-1-3; GH suppression test; MRI of the sella
Sotos syndrome	Skull radiography, cranial CT, or MRI; electroencephalography; renal ultrasonography; echocardiography
Hyperthyroidism	Serum free thyroxine, triiodothyronine, and thyroid-stimulating hormone
Homocystinuria	Plasma cystine, homocysteine, and methionine; urinary homocysteine
Beckwith-Wiedemann syndrome	Serum glucose, insulin; renal ultrasonography; echocardiography; tumor surveillance justified
Marfan syndrome	Spine radiography; echocardiography
Simpson-Golabi-Behmel syndrome	Spine radiography; renal ultrasound; echocardiography; tumor surveillance justified
Klinefelter syndrome	Serum FSH, LH, testosterone; karyotype; tumor surveillance justified
Hypogonadal syndromes	Serum FSH, LH, estradiol, or testosterone; tumor surveillance justified
Familial glucocorticoid deficiency	Serum cortisol, ACTH