Approach to short stature Quiz: Ace Your Exams

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A 5-year-old boy is brought to the pediatrician to establish care after being adopted. The adoptive parents are not aware of significant past medical history or family history. Routine immunizations are up to date. The patient has no symptoms at this time. Height is 8^th percentile, weight is less than 3^rd percentile, and body-mass-index (BMI) is less than 3^rd percentile. Temperature is 37.0°C (98.6°F), pulse is 112/min, respirations are 24/min, blood pressure is 90/52 mmHg, and oxygen saturation is 99% on room air. On physical examination, the patient appears proportional with normal upper-to-lower body segment ratios. Cardiopulmonary and abdominal examinations are normal. Bloodwork is obtained. Complete blood count, complete metabolic panel, inflammatory markers, tissue transglutaminase immunoglobulin A, and growth hormone levels are normal. Which of the following is the most likely cause of short stature in this patient?

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History of prematurity

History of chronic abdominal pain

Presence of a goiter

History of malnutrition

History of skeletal dysplasia