Growth plate disorders causing familiar short stature

Česká verzia

Authors: L. Plachý; D. Zemková; Š. Průhová; J. Lebl
Authors place of work: Pediatrická klinika 2. lékařské fakulty Univerzity Karlovy a Fakultní nemocnice Motol, Praha
Published in the journal: Čes-slov Pediat 2018; 73 (2): 110-117.
Category: Review

Věnováno významnému životnímu jubileu prof. MUDr. Lidky Lisé, DrSc.

Summary

Familial short stature (FSS) is characterised by body height lower than -2 SD if compared with mean height for age, sex and background population, that occurs in two or more subsequent generations. Although the cause for FSS remains not clarified in many individual cases, it may result from autosomal dominantly inherited growth plate disorders. The spectrum of clinical features of growth plate disorders ranges from very mildly expressed forms with proportional short stature up to potentially lethal severe skeletal dysplasia with limb deformities.

Growth plate disorders include subgroups according to underlying mechanisms at molecular level – impaired paracrine signalisation, defects of cartilaginous extracellular matrix, or defective fundamental intracellular functions. FGFR3 or NPR2 gene mutations lead to impaired paracrine signalisation. The defects of cartilaginous extracellular matrix include mutations in genes ACAN, FNB1 or in genes encoding individual types collagen (e.g. COL2A1). Heterozygous mutations of SHOX gene cause 2-15 % of idiopathic short stature.

Clarification of specific diagnosis allows a more precise estimation of final body height, for targeted follow-up with regard to potential complications, for appropriate management and relevant genetic counselling. Team collaboration of paediatric endocrinologist, anthropologist, radiologist and genetician is helpful for both diagnosis and management of affected children.

Key words:
familial short stature, growth plate, bone dysplasia, SHOX, ACAN, FGFR3, NPR2, collagenopathys

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