Background: A compromised final height (FH) is a concern in patients diagnosed with congenital adrenal hyperplasia (CAH). The lack of achievement of the genetic target height (TH) can be attributed to treatment with high doses of corticosteroids and high levels of adrenal androgens. Despite the emergence of new therapeutic modalities such as the use of anti-androgens and growth hormone it has been shown that a favorable FH can be achieved with careful use of corticosteroids.
Objective and hypotheses: Evaluate the FH in patients with CAH comparing it with the TH, using z-scores (zFH and zTH) from the World Health Organization height-for-age Child Growth Standards.
Method: Retrospective study with review of clinical processes.
Results: The study included 23 patients who had already reached the FH: 10 classical forms (seven salt losers and three simple virilizing) and 13 non-classical forms. Eight of our patients were male. All had been treated with corticosteroids, 8 of them started the treatment in the neonatal period and in the remaining patients the average age of onset of treatment was 10.6 years. In 20 patients it was possible to obtain the TH, the median being (Perc 25; Perc 75) −0.92 (−1.29, −0.14). The median (Perc 25; Perc 75) FH was −0.76 (−1.52, 0.44) and corrected final height (zFH - zTH) was 0.09 (−0.17; 0.56). There was no significant difference in corrected final height between classical and non-classical forms.
Conclusion: The authors were able to conclude that, in their sample, although the FH was inferior to the average height in general population, the majority of patients achieved their genetic potential for height. Differences in bone age, time of diagnosis and early initiation of treatment can be key factors in the final height outcome, however the use of corticosteroid therapy alone allowed, in this sample, the achievement of the TH.
10 - 12 Sep 2016
European Society for Paediatric Endocrinology