Tall stature

Parents rarely ask "Is my child too tall?" A tall child is seen as a child with a hereditary predisposition related to height combined with good nutrition and health. This is usually the case. Sometimes it can be annoying when the environment perceives the child as older and more mature due to his/her tall stature and, consequently, has higher expectations.

The child's height (length) is one of the growth parameters that is measured and monitored during regular preventive examinations by a pediatrician, and deviations from the expected values can be noticed easily and in a timely manner. In our environment, the World Health Organization growth charts are used; on these charts, the indicated lines (+/- 2SD relative to the mean value) represent the limit values of the normal growth range of children of the same sex and age. However, when it comes to height, a child whose height significantly exceeds the expected height for his age (achieves a value of + 3 SD on the growth chart) is considered very tall. If the child's height exceeds the limit values, he/she is in good health, there are no other signs of deviation in the clinical picture and the parents or close relatives are tall, then it is the child's expected height.

A child whose height (length) exceeds the upper limit for sex and age or records an unusual growth spurt, or who has some associated health problems, rarely needs a more detailed examination. Possible hereditary causes or increased growth hormone secretion are then considered.

Changes in the genetic or chromosomal basis (Marfan, Sotos, Beckwith-Wiedemann, Klinefelter syndrome...), in addition to prominent growth in height, result in other characteristics in the child's clinical picture that indicate a possible hereditary disorder.    

Bone and muscle growth, and thus growth in height, is strongly influenced by growth hormone. Elevated values of this hormone during the child's growth period, when the cartilage at the ends of the bones is still open, lead to the occurrence of gigantism: very tall stature with long limbs and a prominent chin. In case of elevated growth hormone in adults, after bone growth is completed, a clinical picture of acromegaly will develop, characterized by enlarged hands, feet and prominent facial features. Growth hormone is one of the hormones secreted by the pituitary gland, a small gland located at the base of the brain, just below the part of the brain called the hypothalamus, together with which it regulates the operation of other endocrine glands.

When gigantism is suspected, the child is referred to an endocrinologist for X-ray and laboratory tests in order to assess growth hormone secretion and the condition of the pituitary gland. Sometimes, a smaller tumor is detected in the pituitary gland area, the treatment of which has been more and more successful recently.  

If your child's height significantly exceeds the expected height for the child's calendar age (+ 3SD on the growth chart) or you have noticed an unexpected growth spurt in height, talk to your chosen pediatrician about your child's growth and behavior.