Reduced Final Height Outcome in Congenital Adrenal Hyperplasia under Prednisone Treatment: Deceleration of Growth Velocity during Puberty

[~MaryO~]

http://jcem.endojournals.org/cgi/content/abstract/92/5/1635

 

Journal of Clinical Endocrinology & Metabolism, doi:10.1210/jc.2006-2109

 

The Journal of Clinical Endocrinology & Metabolism Vol. 92, No. 5 1635-1639

Copyright ? 2007 by The Endocrine Society

 

Reduced Final Height Outcome in Congenital Adrenal Hyperplasia under Prednisone Treatment: Deceleration of Growth Velocity during Puberty

Walter Bonfig, Susanne Bechtold, Heinrich Schmidt, Dietrich Knorr and Hans Peter Schwarz

 

University Children?s Hospital, Ludwig Maximilians University, Division of Pediatric Endocrinology, D-80337 Munich, Germany

 

Address all correspondence and requests for reprints to: Walter Bonfig, M.D., University Children?s Hospital, Department of Endocrinology, Ludwig Maximilians University, Lindwurmstr. 4, D-80337 Munich, Germany. E-mail: wbonfig@web.de or walter.bonfig@med.uni-muenchen.de.

 

Context: Normal to decreased final height (FH) has been reported in patients with congenital adrenal hyperplasia (CAH).

 

Objective: The objective was to determine FH outcome and influences of steroid treatment.

 

Methods: The effects of glucocorticoid treatment for classical CAH were retrospectively studied in 125 patients (77 females). Growth pattern, FH, and pubertal development were recorded.

 

Results: Corrected FH was in the lower range of genetic potential [females with simple virilizing (SV)-CAH, ?0.6 ? 1.0 SD score (SDS) vs. females with salt-wasting (SW)-CAH, ?0.6 ? 0.9 SDS; males with SV-CAH, ?1.1 ? 0.9 SDS vs. males with SW-CAH, ?0.9 ? 0.9 SDS]. Total pubertal growth was significantly reduced in comparison with a reference population (females with SV-CAH, 11.9 ? 6.5 cm, and females with SW-CAH, 13.8 ? 7.6 cm vs. reference 20.3 ? 6.8 cm, P

 

Conclusion: Patients with CAH are able to achieve adequate FH with conventional therapy. Total pubertal growth is significantly decreased, and treatment with prednisone results in decreased FH. In addition to biochemical analysis, treatment should be adjusted to normal growth velocity, especially during puberty.