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Long-term Growth in Congenital Adrenal Hyperplasia

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Abstract

Objectives

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.

Methods

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.

Results

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.

Conclusions

Monitoring growth and puberty in children with CAH is critical for optimizing final height.

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Authors and Affiliations

  1. Growth and Pediatric Endocrine Unit, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, 32 Sassoon Road, Pune, 411001, India

    Ankita Maheshwari, Vaman Khadilkar, Priyanka Gangodkar & Anuradha Khadilkar

Authors
  1. Ankita Maheshwari
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  2. Vaman Khadilkar
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  3. Priyanka Gangodkar
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  4. Anuradha Khadilkar
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Contributions

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.

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Correspondence to Anuradha Khadilkar.

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Maheshwari, A., Khadilkar, V., Gangodkar, P. et al. Long-term Growth in Congenital Adrenal Hyperplasia. Indian J Pediatr 86, 154–158 (2019). https://doi.org/10.1007/s12098-018-2753-6

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  • DOI: https://doi.org/10.1007/s12098-018-2753-6

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