Background/aims: Several studies demonstrated rapid growth during the first year of life in infants with congenital adrenal hyperplasia (CAH) which has a considerable effect on final adult height. Whether decreased height potential is caused by inadequate suppression of adrenal androgens, excess steroid therapy or salt wasting itself is a matter of debate. Thus, we aimed to analyze growth pattern in infants with CAH during first year of life and the effect of therapy on those parameters.
Methods: Seventy patients with CAH of different variants were subjected to history and clinical examination. Laboratory and imaging data were obtained from patients records. Height, weight for height and mid parental height SDSs were calculated at diagnosis and at the end of first year.
Results: The mean MPH SDS was −0.3±0.9. Length SDS at the start of treatment (−0.82±0.1) decreased to −1.06±0.11 at the end of first year (P=0.001) with adequate weight gain (height/weight SDS −0.41±0.11 at diagnosis vs −0.16±0.13 at the end of first year, P=0.01). The mean hydrocortisone dose did not differ at diagnosis (14.8±0.4 mg/m2 per day) and at the end of first year (14.98±0.6 mg/m2 per day). Patients required lower doses of fludrocortisone at the end of first year (0.46±0.02 mg/m2 per day at diagnosis vs 0.29±0.01 mg/m2 per day at the end of first year, P<0.001).
Conclusion: At the end of first year, with proper adjustment of therapeutic doses, linear growth acceleration decreased and adequate weight gain occurred in infants with CAH.
20 - 22 Sep 2014
European Society for Paediatric Endocrinology