Avoid ordering screening tests looking for chronic illness or an endocrine cause, including complete blood count, cytidine monophosphate , insulinlike growth factor 1, thyroid tests, and celiac antibodies, in healthy children who are growing at or above the 3rd percentile for height with a normal growth rate (i.e., not crossing percentiles) and with appropriate weight gain.
|Rationale and Comments:||Even in children who are below the 3rd percentile for height with a normal history and physical exam, the incidence of newly diagnosed pathology was found to be only about 1%. In patients who have significant short stature (e.g. ≤ –2.5 standard deviation) or who are well below their genetic potential based on parental heights, tiered or sequential screening may be considered.|
|References:||• Sisley S, Trujillo MV, Khoury J, Backeljauw P. Low incidence of pathology detection and high cost of screening in the evaluation of asymptomatic short children. J Pediatr. 2013 Oct;163(4):1045-51.