short with no explaination?

[PJ88]

My daughter and I kept getting told "she'll grow" but then suddenly they realized she didn't and now it's too late to do anything about it.  They have no explaination on why she didn't grow.  She's 14 yrs old and 4'10".  

One of my concerns is that they test her for any possible problems that could have caused her short stature so she has no surprise problems later.   They mentioned Celiacs and that runs in my family, she has siblings that have not been diagnosed for Celiacs but can't handle wheat, and she has a cousin with celiacs and no symptoms.  (She has no symptoms other than occasional unexplained rashes)  I can't figure out if they've tested her for celiacs.  

The Doctor's letter states "labs are not suspicious for an occult systemic illness, growth hormone deficiency, or thyroid disease."  Does this mean they tested for celiacs or not?

"Labs today reveal a T4 or 4.6 mcg/dL, T3-uptake 31.6%, TSH 1.87 mcIU/mL, IGF-1 450 nbg/mL, sed rate 11, normal CBC, transglutaminase antibody <3 U/mL, and normal chemistry panel."

Can she just have not grown and there be no explanation at all?  I feel like I didn't have enough information on this when she was younger and didn't get her into a specialist and now I've failed her.  I want to make sure I have checked into everything so that I don't miss something I should have known about.

[Deanna L Aftab Guy, MD]

Thanks for the additional information regarding the bone age, children continue to grow until their bones are more like that of a 16 year old, she may have a year of growth yet. A workup can include a blood count, thyroid functions, celiac antibodies and a growth hormone level that is called igf-1, if these were normal she may have had rapid maturation of her growth plates with the onset of puberty
Remind me again how tall you and her dad are?

[PJ88]

We did see an endocrinologist and he said her bone age was 15 and it was too late for him to do anything.  She has started menses.  He said the only thing that could be done now if we wanted to was to find out why she didn't grow.  But then we were ushered out of the office and I am confused.  Is there a reason or isn't there?  When I asked the pediatrician I just recieve the letter with the lab report and a statement that we were fine with it...which we weren't. I feel like the Dr's think they are done and I'm confused about what to do now.

[Deanna L Aftab Guy, MD]

You ask about your 14 year old with short stature, she may not have reached her final height, the most important piece of information that I did not see was a bone age, this is an xray of her left hand that will tell us how much growth she has in her bones.
Her labs show to me that thyroid and celiac are unlikely causes for her lack of growth, but the more specific test for celiac includes a total IgA level along with celiac antibodies, the sed rate measures inflammation and if this is low it is good.
You did not fail her, if her bone age is not 15 or 16 she still has at least a year or more of growth, also if she has not started menses this is good too since she more than likely will continue to grow.
Start with a meeting with her physician rather than relying on a letter, ask about a bone age and if you really want to consult an endocrinologist ask your pediatrician about seeing an endocrinologist, a normal igf-1 does not rule out growth hormone deficiency, a pediatric endocrinologist can rule out this.