Long-term Growth in Congenital Adrenal Hyperplasia.

Abstract

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 ± 3.3mg/m2/d. Mean 17-hydroxy progesterone in boys and girls were 10.8 ± 6.7ng/ml and 11.3 ± 9.3ng/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 ± 8.5cm in boys [target height (TH) -165.5 ± 3.8cm] and in girls it was 149.9 ± 6.7cm [target height (TH) 154.7 ± 6.4cm]. 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.