Constitutional delay of growth and pubertal development: growth hormone secretory pattern and possible therapy.

Constitutional delay of growth and pubertal development is a frequent cause of short stature. These children have a significant retardation of skeletal age and delayed sexual development. They generally maintain a normal growth curve and tend to attain normal adult height. Although children with constitutional delay of growth are believed to have no medical or endocrine abnormality to explain their short stature, some controversy regarding their growth hormone secretory status has recently surfaced; some authors have reported low growth hormone levels to provocative stimuli and decreased growth hormone secretion during sleep, as well as low somatomedin C values in some children with constitutional delay of growth. Others, however, have found the growth hormone secretory status to be normal and similar to that of a control population. The implications of these findings, particularly in regard to possible forms of therapy, are discussed in some detail.