Idiopathic short stature
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Idiopathic short stature (ISS) refers to extreme short stature that does not have a diagnostic explanation (idiopathic designates a condition that is unexplained or not understood) after an ordinary growth evaluation. The term has been in use since at least 1975<ref name="pmid1105371">Template:Cite journal</ref> without a precise percentile or statistical definition of "extreme".
Diagnosis
Definition
In 2003 Eli Lilly and Company offered a more precise definition of ISS when the pharmaceutical company submitted clinical trial data to the U.S. Food and Drug Administration (FDA) requesting approval to advertise their brand of growth hormone for the treatment of ISS.<ref>Template:Cite journal</ref> They proposed a definition of a height more than 2.25 standard deviations below mean, roughly equal to the shortest 1.2% of the population. <ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref>
Other researchers have described a cutoff of 2.0 standard deviations.<ref name="pmid16213173">Template:Cite journal</ref>
Treatment
There is some evidence that hormone treatment may not result in a significant improvement in psychosocial functioning.<ref name="pmid16632673">Template:Cite journal</ref>
It is estimated that it would cost US$100,000 or more <ref>Template:Cite journal</ref> to treat someone, but might only move them from the first percentile to perhaps the 10th. There is some ethical and economic concern whether such treatment would merely shift discrimination to the next most affected percentile. Template:Citation neededThe use of insulin-like growth factor 1<ref name="pmid17785695">Template:Cite journal</ref> or aromatase inhibitors<ref name="pmid17901908">Template:Cite journal</ref> have been proposed as an alternative to growth hormone.