title: Gonadotropin releasing hormone analog treatment in children with congenital adrenal hyperplasia complicated by central precocious puberty.
abstract: OBJECTIVE
  Congenital adrenal hyperplasia (CAH) can be complicated by central precocious puberty (CPP) in children, which may compromise final height. We aimed to evaluate the effect of gonadotropin-releasing hormone analog (GnRHa) therapy on growth in children with CAH.
  
  
  METHODS
  Twelve children with CAH were enrolled in a follow-up study. Eight patients underwent the GnRH stimulation test. GnRHa-treatment was administered at 3.75 mg every 4 weeks; the dose had to be increased to 7.5 mg in three patients. Bone age, growth velocities and body mass index of the patients were monitored during treatment.
  
  
  RESULTS
  Median chronologic age and bone age at diagnosis were 6.8 (3.5) years and 11 (1.2) years, respectively. Median follow-up was 4.4 (4.9) years. A significant difference was found in the median ratio of bone age to chronological age between diagnosis and last visit (p=0.005) and between the beginning of GnRHa treatment and last visit (p=0.004). Median growth velocity was 4 (2.5) cm, 3.4 (5.2) cm and 5.5 (5.5) cm at the end of the first, second and third years of the therapy, respectively. Second-year growth velocity was inversely correlated with median bone age at diagnosis (rho:-0.758, p=0.004) and at the initiation of therapy (rho:-0.876, p<0.001).
  
  
  CONCLUSIONS
  GnRHa therapy should be considered for augmentation of linear growth and diminishment of bone age advancement in children with CAH complicated by CPP, particularly in children who do not have extremely advanced bone age for chronological age.
authors.affiliation: Göztepe Education and Research Hospital, Pediatric Endocrinology Clinic, İstanbul, Türkiye.
authors.forename: Ayla
authors.initials: A
authors.lastname: Güven
authors.affiliation: Göztepe Education and Research Hospital, Pediatric Endocrinology Clinic, İstanbul, Türkiye.
authors.forename: Ayşe
authors.initials: A
authors.lastname: Nurcan Cebeci
authors.affiliation: Göztepe Education and Research Hospital, Pediatric Endocrinology Clinic, İstanbul, Türkiye.
authors.forename: Suna
authors.initials: S
authors.lastname: Hancili
mesh_terms: D000312:Adrenal Hyperplasia, Congenital / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D001827:Body Height / Q000187:drug effects; D002648:Child; D002675:Child, Preschool; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D005500:Follow-Up Studies; D006801:Humans; D006854:Hydrocortisone / Q000494:pharmacology / Q000627:therapeutic use; D016729:Leuprolide / Q000494:pharmacology / Q000627:therapeutic use*; D007986:Luteinizing Hormone / Q000097:blood; D008297:Male; D011629:Puberty, Precocious / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone; D016729:Leuprolide; D006854:Hydrocortisone