Constitutional growth delay


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Constitutional growth delay

Endocrine system

Adrenal gland disorders

Congenital adrenal hyperplasia

Primary adrenal insufficiency

Waterhouse-Friderichsen syndrome


Adrenal cortical carcinoma

Cushing syndrome

Conn syndrome

Thyroid gland disorders

Thyroglossal duct cyst


Graves disease

Thyroid eye disease (NORD)

Toxic multinodular goiter

Thyroid storm


Euthyroid sick syndrome

Hashimoto thyroiditis

Subacute granulomatous thyroiditis

Riedel thyroiditis

Postpartum thyroiditis

Thyroid cancer

Parathyroid gland disorders





Pancreatic disorders

Diabetes mellitus

Diabetic retinopathy

Diabetic nephropathy

Pituitary gland disorders


Pituitary adenoma






Growth hormone deficiency

Pituitary apoplexy

Sheehan syndrome


Constitutional growth delay

Diabetes insipidus

Syndrome of inappropriate antidiuretic hormone secretion (SIADH)

Gonadal dysfunction

Precocious puberty

Delayed puberty

Premature ovarian failure

Polycystic ovary syndrome

Androgen insensitivity syndrome

Kallmann syndrome

5-alpha-reductase deficiency

Polyglandular syndromes

Autoimmune polyglandular syndrome type 1 (NORD)

Endocrine tumors

Multiple endocrine neoplasia

Pancreatic neuroendocrine neoplasms

Zollinger-Ellison syndrome

Carcinoid syndrome



Opsoclonus myoclonus syndrome (NORD)

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


Constitutional growth delay


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High Yield Notes

13 pages


Constitutional growth delay

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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.


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.


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  3. "Pathophysiology of Disease: An Introduction to Clinical Medicine 8E" McGraw-Hill Education / Medical (2018)
  4. "CURRENT Medical Diagnosis and Treatment 2020" McGraw-Hill Education / Medical (2019)
  5. "Harrison's Endocrinology, 4E" McGraw-Hill Education / Medical (2016)
  6. "Recent advances in the understanding and management of delayed puberty" Archives of Disease in Childhood (2015)
  7. "Constitutional delay of puberty versus congenital hypogonadotropic hypogonadism: Genetics, management and updates" Best Practice & Research Clinical Endocrinology & Metabolism (2019)

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