A 9-year-old boy has height below 3rd centile, bone age delayed by 3 years, low IGF-1, and peak GH <10 ng/mL on stimulation. The diagnosis is:

• A Growth hormone deficiency ✓
• B Constitutional growth delay
• C Hypothyroidism
• D Idiopathic short stature

Explanation

Growth hormone deficiency is confirmed by low IGF-1 and peak GH <10 ng/mL on two stimulation tests. Constitutional delay has normal GH and IGF-1, with bone age delay consistent with height age. Hypothyroidism would have elevated TSH. Idiopathic short stature is a diagnosis of exclusion with normal GH.

Reference: Nelson Textbook of Pediatrics, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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