If a child looks normal and has a normal growth velocity, constitutional tall stature is usually present (Fig. 14.31). Obese children are often taller than average for their age, and if maturity is also advanced, then puberty may occasionally occur earlier. Tall stature may represent a considerable handicap and, if necessary, treatment to limit growth should be considered.
There are two approaches to the treatment of an excessive height prediction: to induce puberty early with replacement doses of sex steroids; or to reduce growth velocity by inhibiting GH secretion during the childhood phase of growth using octreotide (a long- acting analogue of somatostatin), which is also used as an adjunct to pituitary surgery in gigantism. The first approach is standard and achieves a reduction in height, achieved in relation to the age at which puberty is induced. The second is not routine at present.
