Son's biological 'clock' is running late


June 01, 1993|By Dr. Modena Wilson and Dr. Alain Joffe | Dr. Modena Wilson and Dr. Alain Joffe,Contributing Writers

My 15-year-old son has always been on the short side and has not yet gone into puberty. His doctor did a lot of blood tests and some X-rays and told us that everything would be fine. It just seems like there has to be something wrong with him.

Although we can appreciate your concern about your son's health and lack of development, we believe that your doctor has given you correct information.

Based on what you've told us, it sounds as if your son has what is called normal variant constitutional delay. This is a fancy way of saying that your son's biological "clock" is quite normal but is destined (probably under the influence of genes he inherited from his parents) to turn on later than those of his friends. Typically, such individuals tend to be on the small side throughout childhood and fall further behind their peers during adolescence because their growth spurt is delayed. Often, one or more family members had a similar growth pattern.

In order to make such a diagnosis, doctors need to rule out a variety of conditions that can affect growth and make certain that the systems controlling growth are normal. Hence the need for blood tests. Your son's X-rays probably showed bony development (bone age) appropriate to an individual at least several years younger than your son; this confirms the remaining potential for growth.

Dr. Wilson is director of general pediatrics at the Johns Hopkins Children's Center; Dr. Joffe is director of adolescent medicine.

Baltimore Sun Articles
Please note the green-lined linked article text has been applied commercially without any involvement from our newsroom editors, reporters or any other editorial staff.