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Arquivos Brasileiros de Endocrinologia & Metabologia
On-line version ISSN 1677-9487
SILVA, Ivani Novato; CUNHA, Cristiane F.; ANTONIO, Samuel D. and ANDRADE, Guilherme F.M.P.. Growth rate of children with congenital adrenal hyperplasia during treatment with low doses of hydrocortisone. Arq Bras Endocrinol Metab [online]. 2005, vol.49, n.1, pp. 120-125. ISSN 1677-9487. http://dx.doi.org/10.1590/S0004-27302005000100016.
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 ± 2.0mg/m2 and 0.1mg 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.
Keywords : Congenital adrenal hyperplasia; 21-hydroxilase deficiency; Glucocorticoids; Growth; Hydrocortisone.