Pathological or idiopathic short stature? Differential diagnosis in a woman from an Identified Skeletal Collection (University of Coimbra)

MARIO ARRIETA; ANA LUISA SANTOS

Coimbra

Jornada; V Jornadas Portuguesas de Paleopatologia; 2016

Universidade de Coimbra. Centro de Investigação em Antropologia e Saúde

Short stature may result from familial genetic, chondrodysplasias, endocrine, malnutrition, and/or chronic illnesses. Idiopathic short stature is defined as a height that is two or more standard deviations (s.d.) below the mean for age/sex in the population, in the absence of another diagnosis. This work discusses the possible etiology for the short stature of a 26-years-old female (sk.#131, Coimbra Identified Skeletal Collection), who died of measles in 1920. Her skull and long bones were measured according to standard descriptions. Her estimated height is 138.91-144.3cm, approximately 3 s.d. below the average female stature for early 20th century Portugal. The crural, brachial, humero-femoral and intermembral indexes show a proportionate body, uncommon in dwarfism. Skeleton examination revealed a small skull, with prominent frontal, obliterated sagittal suture, cribra orbitalia, prognathism, long/ oval foramen magnum, and a small mandible with masculine features. Teeth have multi enamel hypoplasias. Ribs sternal ends are flattened/wider and vertebrae with developmental defects (eg. atlas with left transverse foramen and posterior tubercle both open, absence of the right transverse foramen in axis, sacrum with six vertebrae). The differential diagnoses take into account clinical and paleopathological knowledge. Among the possible diseases responsible for skeletal changes are hypopituitarism, malnutrition or chronic diseases during childhood. However, other conditions or the synergistic action of two or more stressors agents cannot be ruled out.