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January 1975

The Child With "Excessive" Height Prediction: Clinical Dilemma

Author Affiliations

Department of Pediatrics State University of New York Upstate Medical Center 750 E Adams St Syracuse, NY 13210

Am J Dis Child. 1975;129(1):17-18. doi:10.1001/archpedi.1975.02120380009002

Elsewhere in this issue (see page 95), Ruvalcaba et al report the use of androgen therapy as a pharmacological approach to the problem of the unusually tall boy. This case study exemplifies a clinical dilemma for us all to contemplate—the tall girl or boy whose height prediction is unacceptable either to the child or the parents, and who request(s) pharmacological intervention by the physician to cause earlier epiphyseal fusion. Thus the physician is caught between the upper and nether millstones: the easiest path is to accede to the intense pressures put on him by the family to "do something," but then he must live with the uncertainty that the therapy he has used may eventually do harm to the patient. The physician's fears about the long-term uncertainties of estrogen or androgen therapy in otherwise healthy girls or boys may be difficult to communicate to the parent or child whose attention

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