Constitutional Delay Of Growth And Puberty Pdf

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The child experiences normal growth and maturation, but at a slower than average pace. Such children are often the smallest in their school class. The physical changes of puberty and the pubertal growth spurt occur later in these children with constitutional delay.

Constitutional Delay in Growth and Puberty

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In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript. Children with CDGP exhibit a characteristic pattern of growth during their infancy and childhood.

Some of these patients show a severe deceleration of growth velocity before puberty. Although some authors have suggested that a transitory GH deficiency secretory pattern can be observed at that moment, there is not a universal agreement in this matter. To test the hypothesis of whether or not a diminution in GH secretion strikes before puberty in children with CDGP, we studied the spontaneous GH secretory profile by measuring GH plasma levels at 30 minute intervals for 24 hr in prepubertal children Tanner I stage ; 37 children were controls 24 boys and 13 girls and 70 were patients with CDGP 44 boys and 26 girls.

Conclusion : Patients in the prepubertal period of life with CDGP exhibit a spontaneous GH secretion that is quantitatively similar to normal children in the same period of life.

Hence, we postulate that the decrease of growth velocity that some patients with CDGP show is not due to a transitory GH deficiency. Reprints and Permissions. Pozo, J. Pediatr Res 33, S85 Download citation. Issue Date : 01 May Advanced search. Skip to main content Thank you for visiting nature. Download PDF. Abstract Children with CDGP exhibit a characteristic pattern of growth during their infancy and childhood. View author publications. Rights and permissions Reprints and Permissions.

About this article Cite this article Pozo, J. Search Search articles by keyword or author Search.

An approach to constitutional delay of growth and puberty

During a year period, 23 girls compared to boys presented with constitutional delay in growth and puberty. Of these girls, 15 were followed to final height to determine the outcome of the untreated condition in terms of both growth and psychological well-being. At presentation chronological age was Mean age at menarche was Psychological questionnaires revealed no significant difference in self-esteem, marital or employment status between the patient and control groups. This study demonstrates that girls with constitutional delay in growth and puberty reached their PAH, although this was lower than the midparental heights. The girls also experienced significant distress due to delayed growth and puberty and treatment to advance growth should be considered more frequently.

Constitutional delay of puberty: presentation and inheritance pattern in 48 familial cases

Learn more. Patient Education Dec 13 Once puberty begins, it progresses as expected, followed by the pubertal growth spurt. These children will typically have an adult height that is within range of what is expected for their genetic potential.

Constitutional delay of growth and puberty is a transient state of hypogonadotropic hypogonadism associated with prolongation of childhood phase of growth, delayed skeletal maturation, delayed and attenuated pubertal growth spurt, and relatively low insulin-like growth factor-1 secretion. In a considerable number of cases, the final adult height Ht does not reach the mid-parental or the predicted adult Ht for the individual, with some degree of disproportionately short trunk.

Growth Delay

Albanese, Assunta ; Growth and segmental proportion in children with prepubertal growth delay and constitutional delay of growth and puberty: Natural history and the effect of therapeutic intervention. Doctoral thesis Ph. Despite being considered a variant of normal, constitutional delay of growth and puberty CDGP is a condition which should be regarded as a disorder. Final height and body proportion attainment in boys and girls who had a delayed onset of pubertal development were retrospectively analysed. Final height was below both genetic target and the expected normal range for the adult population.

Constitutional delay of growth and puberty CDGP is the most common cause of pubertal delay. CDGP is defined as the proportion of the normal population who experience pubertal onset at least 2 SD later than the population mean, representing 2. While adolescents with CDGP spontaneously enter puberty, they are at risk for short stature, decreased bone mineral density, and psychosocial problems. Genetic factors contribute heavily to the timing of puberty, but the vast majority of CDGP cases remain biologically unexplained, and there is no definitive test to distinguish CDGP from pathological absence of puberty during adolescence.


Constitutional delay of growth and puberty is a transient state of hypogonadotropic hypogonadism associated with prolongation of childhood phase of growth, delayed skeletal maturation, delayed and attenuated pubertal growth spurt, and relatively low insulin-like growth factor-1 secretion.


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Constitutional delay of growth and puberty CDGP is a term describing a temporary delay in the skeletal growth and thus height of a child with no physical abnormalities causing the delay. Typically at some point during childhood, growth slows down, eventually resuming at a normal rate. CDGP is the most common cause of short stature and delayed puberty. Children with constitutional delay of growth and puberty CDGP , the most common cause of short stature and pubertal delay in males, typically have slowed linear growth within the first 3 years of life. In this variant of normal growth, linear growth velocity and weight gain slows beginning as young as age 3—6 months, resulting in downward crossing of growth percentiles, which often continues until age 2—3 years. At that time, growth resumes at a normal rate, and these children grow either along the lower growth percentiles or beneath the curve but parallel to it for the remainder of the prepubertal years. At the expected time of puberty, the height of children with CDGP begins to drift further from the growth curve because of delay in the onset of the pubertal growth spurt.

Constitutional growth delay