Tall Stature

Starting Point

• Height SDS > +2SDS or Height-TH > +2SDS → Dysmorphic?
• Height < +2SDS but typical dysmorphic features → Yes (Disproportionate?)

Dysmorphic? — No

• (Recent) growth acceleration?
• No → Height-TH > +2SDS? • No → Familial tall stature • Yes → Obesity, Estrogen deficiency/insensitivity
• Yes → Puberty signs? • No → Pituitary gigantism, Hyperthyroidism • Yes → Precocious puberty, Pseudoprecocious puberty, Constitutional advance in puberty

Dysmorphic? — Yes — Disproportionate?

• No → Overgrowth syndromes: Sotos syndrome Weaver syndrome Nevo syndrome Beckwith-Wiedemann syndrome Simpson-Golabi-Behmel syndrome PTEN-hamartoma syndrome
• Yes → Overgrowth syndromes: Klinefelter syndrome Marfan syndrome Marfan type II syndrome CCA/Beals syndrome Homocystinuria Lujan-Fryns syndrome Other: Estrogen deficiency or insensitivity