Constitutional growth delay
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Constitutional growth delay
Endocrine system
Adrenal gland disorders
Congenital adrenal hyperplasia
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Pituitary apoplexy
Sheehan syndrome
Hypoprolactinemia
Constitutional growth delay
Diabetes insipidus
Syndrome of inappropriate antidiuretic hormone secretion (SIADH)
Gonadal dysfunction
Precocious puberty
Delayed puberty
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Endocrine system pathology review
Adrenal insufficiency: Pathology review
Adrenal masses: Pathology review
Hyperthyroidism: Pathology review
Hypothyroidism: Pathology review
Thyroid nodules and thyroid cancer: Pathology review
Parathyroid disorders and calcium imbalance: Pathology review
Diabetes mellitus: Pathology review
Cushing syndrome and Cushing disease: Pathology review
Pituitary tumors: Pathology review
Hypopituitarism: Pathology review
Diabetes insipidus and SIADH: Pathology review
Multiple endocrine neoplasia: Pathology review
Neuroendocrine tumors of the gastrointestinal system: Pathology review
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Contributors
Sam Gillespie, BSc
Constitutional growth delay is a normal variation of development where there’s a temporary delay in growth that occurs during early childhood and puberty.
You can think of it as a slowed rate of maturation, which happens normally in some people.
It’s the most common cause of short stature and pubertal delay in children and adolescents, but by adulthood, people with constitutional growth delay generally end up with normal adult heights.
Generally speaking, there are two hormonal systems that control growth - the growth hormone axis and the hypothalamic-pituitary-gonadal axis.
The growth hormone axis starts with the hypothalamus which is at the base of the brain.
The hypothalamus secretes growth hormone-releasing hormone and that stimulates the anterior pituitary gland to produce growth hormone.
Now, growth hormone affects lots of tissues - in particular it makes the body retains nitrogen leading to more muscle growth, and osteoblasts get stimulated which causes the bones to thicken.
Growth hormone also stimulates certain tissues like the liver, skeletal muscles, bones, and kidneys to produce somatomedin C, also called insulin-like growth factor 1.
Insulin-like growth factor 1 promotes cellular metabolism, prevents cell death, and helps cell divide and differentiate throughout the body.
It’s also the key hormone that stimulates the growth in length of long bones.
Now, sexual maturation is under the control of the hypothalamic-pituitary-gonadal axis.
This axis also starts with the hypothalamus which releases Gonadotropin-releasing hormone, or GnRH which stimulates the anterior pituitary to produce the gonadotropin hormones: luteinizing hormone, or LH, and follicle-stimulating hormone, or FSH.
Summary
Constitutional growth delay (CGD) is a condition in which some children grow slowly during early childhood and puberty compared to their peers. CGD is the most common cause of short stature in children and pubertal delay in adolescents. It is considered a normal variation to growth because individuals with constitutional growth delay usually end up achieving normal adult heights by adulthood.
Sources
- "Robbins Basic Pathology" Elsevier (2017)
- "Harrison's Principles of Internal Medicine, Twentieth Edition (Vol.1 & Vol.2)" McGraw-Hill Education / Medical (2018)
- "Pathophysiology of Disease: An Introduction to Clinical Medicine 8E" McGraw-Hill Education / Medical (2018)
- "CURRENT Medical Diagnosis and Treatment 2020" McGraw-Hill Education / Medical (2019)
- "Harrison's Endocrinology, 4E" McGraw-Hill Education / Medical (2016)
- "Recent advances in the understanding and management of delayed puberty" Archives of Disease in Childhood (2015)
- "Constitutional delay of puberty versus congenital hypogonadotropic hypogonadism: Genetics, management and updates" Best Practice & Research Clinical Endocrinology & Metabolism (2019)
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