American Academy of Pediatrics – Section on Endocrinology

View all recommendations from this society

October 2, 2017

Avoid ordering screening tests looking for chronic illness or an endocrine cause, including CBC, CMP, IGF-1, thyroid tests, and celiac antibodies, in healthy children who are growing at or above the 3rd percentile for height with a normal growth rate (i.e., not crossing percentiles) and with appropriate weight gain.

Even in children who are below the 3rd percentile for height with a normal history and physical exam, the incidence of newly diagnosed pathology was found to be only about 1%. In patients who have significant short stature (e.g. ≤-2.5 SD) or who are well below their genetic potential based on parental heights, tiered or sequential screening may be considered.

These items are provided solely for informational purposes and are not intended as a substitute for consultation with a medical professional. Patients with any specific questions about the items on this list or their individual situation should consult their physician.

How The List Was Created

The American Academy of Pediatrics’ Section on Endocrinology (SOEn) consists of pediatric endocrinologists, pediatricians, and allied health care professionals who are actively involved in some aspect of the study of endocrinological disease in infants, children and adolescents. SOEn strives to inform pediatricians, parents, communities and policy makers on endocrinological disease in children. Thus, the Executive Committee of SOEn was queried to develop a list of on diagnostic and management decisions that have resulted in patient harm either from a misdiagnosis or inappropriate therapy. The list was shared with membership of the Section on Endocrinology for feedback and then finalized by the SOEn Executive Committee. These five clinical issues are the result. Consensus on the items was received from 20 AAP expert groups. The list was critically reviewed and approved by the AAP Executive Committee.

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Sisley S, Trujillo MV, Khoury J, Backeljauw P. Low incidence of pathology detection and high cost of screening in the evaluation of asymptomatic short children. J Pediatr. 2013 Oct;163(4):1045-51.