Jason Garrett

Jason Garrett is brought in to see Dr. Heaney, a local pediatric endocrinologist. In reviewing the patient’s chart, Dr. Heaney notes that the patient is followed by Dr. Sanchez. Dr. Heaney knows that Dr. Sanchez is a very good pediatrician and reviews Dr. Sanchez’s notes.

Jason Garret is a 13 yo boy who has been seen since birth by Dr. Sanchez. It was noted that over the last 7 or so years, the parents had brought Jason in to see Dr. Sanchez on numerous occasions. At first the visits were scheduled due to behavioral issues in school. Over time, the parents wanted him tested because his grades began to fall. In time, Jason underwent neuropsychiatric testing and it was noted that he met criteria for a diagnosis for ADHD. Jason was placed on Ritalin and the parents seem to think that his behavior in school improved, as did his grades.

Dr. Sanchez also notes that Jason has always been small for his age. Since birth and at virtually every well-child check-up Jason was in the lowest percentile for height. He loves sports and especially basketball. The parents have brought Jason to see Dr. Sanchez for every month for three months, and at each visit they ask Dr. Sanchez to begin Human Growth Hormone for Jason. Dr. Sanchez runs a Growth Hormone level and Jason's Growth Hormone Level and other hormonal panels are normal.  He notes that given Jason’s growth pattern that he is likely going to be 5’4” tall.

Dr. Heaney goes in to see Jason and his parents. They are there for a consult for his shortness. The parents have done their research and note that shorter people are often picked on in school and they are sure this is the source of many of Jason’s problems at school. They note that Jason gets in a lot of fights because the other kids pick on him for his size. They also note that if Jason could be more successful in sports that he will have more confidence and be more successful in his academic work. They also note that on average, for every inch in height that a man is over 5’8” tall, he makes about $600 per year per inch more. After an interview, physical exam, and review of the chart, Dr. Heaney diagnoses Jason with Idiopathic Short Stature Syndrome.

Dr. Heaney knows that at most Human Growth Hormone can gain Jason between 0.75 and 3 inches in height.

Should Dr. Heaney give Jason the hormone?