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.

Sponsoring Organizations

American Academy of Pediatrics – Section on Endocrinology

Sources

Expert consensus

Disciplines

Endocrinologic
Pediatric

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.