ESPE Abstracts

Background: Congenital Adrenal Hyperplasia (CAH) is a complex endocrine condition with varying presentations, one of which includes precocious puberty. Understanding how precocious puberty affects clinical parameters in pediatric CAH patients is crucial for optimizing management strategies.

Methods: This study conducted a comprehensive statistical analysis comparing pediatric CAH patients with precocious puberty (n = 8) to those without (n = 81). Key parameters examined included age, hypertension, treatment compliance, Weight-for-Age Z-score (WAZ), Height-for-Age Z-score (HAZ), Body Mass Index (BMI), BMI Z-score (BMIZ), bone age standard deviation (SD), hydrocortisone dose, and levels of 17-Hydroxyprogesterone (17OHP) and Adrenocorticotropic Hormone (ACTH).

Results: Eight patients (6 males and 2 females) had precocious puberty in the course of the disease, 7/8 with 11 B-OH D, and 1 with 21-OHP deficiency. The analysis revealed statistically significant differences in four primary areas: age (P = 0.0010), occurrence of precocious puberty (P = 0.0000013), compliance to treatment (P = 0.0419), and BMI (P = 0.0000027). These findings indicate that age and BMI are correlated with the development of precocious puberty in CAH patients. Additionally, the group with precocious puberty showed notably different treatment compliance and required significantly higher hydrocortisone doses (P = 0.0000026). No significant differences were found in hypertension, WAZ, HAZ, BMIZ, bone age SD, last measured 17OHP, and ACTH levels.

Conclusion: The study highlights significant differences in age, BMI, treatment compliance, and hydrocortisone dosing in pediatric CAH patients with precocious puberty compared to those without. These findings underscore the importance of monitoring these parameters closely in the management of CAH, particularly in patients exhibiting precocious puberty. The data suggest a more aggressive management approach might be necessary for patients with CAH and precocious puberty. Further research is warranted to explore the underlying mechanisms and long-term implications of these associations.