[Growth rate of children with congenital adrenal hyperplasia during treatment with low doses of hydrocortisone].
We evaluated linear growth of 27 children with congenital adrenal hyperplasia (CAH) treated with low doses of oral hydrocortisone. They were followed-up during 6.1 +/- 1.8 years with daily hydrocortisone doses of 10.84 +/- 2.0 mg/m2 and 0.1 mg fludrocortisone (24 of them). Twenty-three were female. Mean chronological age (CA) was 6.1 +/- 2.9 years and bone age (BA) 6.9 +/- 3.3 (r = 0.66) at the beginning of the study. Five children showed BA advancement > 2 years relating to CA. It was calculated Height SD for CA (SD/H) and for BA (SD/BA) were calculated using NCHS as reference pattern. At the beginning of the study SD/H was -0.8 +/- 1.9 and corresponding SD/BA was -1.5 +/- 2.1; at the end SD/H was -0.17 +/- 1.5 and SD/BA was -1.34 +/- 1.2 (p = 0.02 and p = 0.51, respectively for the beginning and the end). BA changed 1.3 +/- 0.3 per year during this period. Children with advanced BA showed an improvement of SD/BA, from -4.55 +/- 0.9 at from the beginning, -4.55 +/- 0.9 to -2.48 +/- 0.4 at the end of follow-up, -2.48 +/- 0.4 (p = 0.003). The elevated plasma levels of 17-OH Progesterone (17OHP) and androstenedione showed further increase during follow-up. We conclude that children with CAH receiving low doses of hydrocortisone showed adequate growth during the follow-up, without excessive BA advancement, even though full suppression of plasma levels of 17OHP and androgens wasere not achieved.
Divisão de Endocrinologia Infantil e do Adolescente, Departamento de Pediatria, Hospital de Clínicas, Faculdade de Medicina, UFMG, Belo Horizonte, MG. ivanins@medicina.ufmg.br
Ivani Novato
IN
Silva
Cristiane F
CF
Cunha
Samuel D
SD
Antônio
Guilherme F M P
GF
Andrade
D000312:Adrenal Hyperplasia, Congenital / Q000188:drug therapy* / Q000503:physiopathology*; D002648:Child; D002657:Child Development; D005260:Female; D006128:Growth; D006801:Humans; D006854:Hydrocortisone / Q000008:administration & dosage*; D008297:Male
D006854:Hydrocortisone