Long-term Growth in Congenital Adrenal Hyperplasia
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To retrospectively assess growth of children with congenital adrenal hyperplasia (CAH) with special reference to puberty and to assess longitudinal growth and final height of subset of children with CAH.
A retrospective analysis of 30 children (14 boys) with classic CAH (11 salt wasters, 19 simple virilisers) followed up for a mean duration of 9.9 ± 2.4 y (Study period December 2002 through December 2016) was performed. Height Z scores, target height Z scores, height velocities and laboratory parameters were analysed.
Children were treated with hydrocortisone in a mean dose of 15.7 ± 3.3 mg/m2/d. Mean 17-hydroxy progesterone in boys and girls were 10.8 ± 6.7 ng/ml and 11.3 ± 9.3 ng/ml respectively. Fifteen children (7 boys) developed central precocious puberty at mean age of 7.6 ± 1.8 y and 13 were treated with GnRH analogues for 3.5 y. Of all patients, 18 (10 girls, 8 boys) reached final height at a mean age of 14.2 ± 1.6 y. Mean final height achieved was 158.0 ± 8.5 cm in boys [target height (TH) -165.5 ± 3.8 cm] and in girls it was 149.9 ± 6.7 cm [target height (TH) 154.7 ± 6.4 cm]. Final height standard deviation scores (SDS) for boys and girls were − 2.06 ± 1.1 (TH-SDS -1.06 ± 0.5) and − 1.47 ± 1.1 (TH-SDS -0.56 ± 1.2) respectively and were not significantly different from target height Z scores (p > 0.05). Growth velocity was attenuated during pubertal years.
Monitoring growth and puberty in children with CAH is critical for optimizing final height.
KeywordsCAH Growth Adult height
VK: Design and concept of the study, design, revision and final submission of manuscript; AM: Design and concept of the study, data collection, initial analysis, design and final submission of the manuscript; PG: Data collection, design and final submission of the manuscript; AK: Initial analysis, revision and final submission of the manuscript; VK will act as guarantor for this paper.
Compliance with Ethical Standards
Conflict of Interest
- 8.Dattani MT, Ziaferi VT, Hindmarsh PC. Evaluation of disordered puberty. In: Brook CGD, Clayton P, Brown RS, editors. Brook’s clinical pediatric endocrinology. 6th ed. United Kingdom: Wiley Blackwell; 2009. p. 213–38.Google Scholar
- 10.Gilsasz V, Ratib O. Hand bone age: a digital atlas of skeletal maturity. United Kingdom: Springer; 2011.Google Scholar
- 11.Tanner JM, Healy M, Goldstein H, Cameron N. Assessment of skeletal maturity and prediction of adult height (TW3 method). 3rd ed. London: WB Saunders, Harcourt Publishers Ltd; 2001.Google Scholar
- 12.Miller WL. The adrenal cortex and its disorders. In: Brook CGD, Clayton P, Brown RS, editors. Brook’s clinical pediatric endocrinology. 6th ed. United Kingdom: Wiley Blackwell; 2009. p. 283–325.Google Scholar
- 14.Gueven A, Nurcan Cebeci A, Hancili S. Gonadotropin releasing hormone analog treatment in children with congenital adrenal hyperplasia complicated by central precocious puberty. Hormones (Athens). 2015;14:265–71.Google Scholar