A 6 year old girl is brought to the clinic by her father because of concerns that she is shorter than other children her age. She has a history of wheezing with viral illnessess as a toddler. Family history reveals that Dad is 5'9'', mom is 5'4'' and dad first shaved at age 17. On examination, she is well appearing, but looks younger than chronologic age. Plotting her growth reveals the following: Height and weight have been at the 10th percentile since infancy.

Respiratory examination: Normal. 
Cardiovascular examination:There is a grade 2/6 systolic ejection murmur at the left lower sternal border that is best heard when the child is supine. 
Abdominal examination: Soft and nondistended.
Musculoskeletal examination: Unremarkable.
Skin examination: Normal.

 

The most likely diagnosis for this child’s short stature is?

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Authors

Dr. Joanna Holland

joanna.holland@iwk.nshealth.ca

Dr. Karen Forbes

Reviewer

Dr. Mumtaz Virjii

mvirji2@cw.bc.ca