Tall stature

Some children are clearly taller than their peers from a young age. Other children suddenly start to grow faster and surpass their peers. So “being tall” and “growing fast” can mean several things.  

• A height above the “top line 97th percentile or +2 standard deviations” on the growth curve from a young age. This is often seen in children with tall parents. 
• A growth rate that suddenly increases. The child’s growth curve crosses the percentile lines towards higher percentiles, for example from the 10th to the 90th percentile. Height can still fall within the normal range. This growth pattern is suspicious and should certainly be investigated further. 
• A height that is still within the curve, but large in relation to the height of the parents. This growth pattern is also unusual and deserves further investigation. 

Familial tall stature

Endocrine disorders

• Hyperthyroidism
• Obesity
• Pituitary gigantism
• Precocious puberty

Genetic disorders

• Disproportional overgrowth
  • Beckwith-Wiedemann syndrome
  • Homocystinuria
  • Klinefelter syndrome (XXY)
  • Marfan syndrome
• Proportional overgrowth
  • Fragile X syndrome
  • Sotos syndrome
  • Weaver syndrome

To know if a child is tall or short, his/her height is compared with the height of other boys or girls. This can be done by plotting the height on a ‘growth curve’.  The curve should be adapted to the child’s ethnic background, gender and age.  

The position of a child’s height on the growth curve is not all that matters. It is also important to observe whether the child has upwards crossed the percentiles (growth acceleration).  

See above

Treatment, if applicable, depends on the cause of the tall stature.