Author/Editor     Hargitai, Gabor; Bratanič, N; Dolžan, V; Kržišnik, C; Repič-Lampert, B; Stopar, M; Trebušak, K; Uršič-Bratina, N; Žerjav-Tanšek, M
Title     Growth patterns and final height in congenital adrenal hyperplasia due to classical 21-hydroxylase deficiency
Type     članek
Source     Horm Res
Vol. and No.     Letnik 55
Publication year     2001
Volume     str. 161-71
Language     eng
Abstract     Background: Longitudinal growth and bone age (BA) development are the most important clinical parameters for monitoring adequate glucocorticoid replacement in children with congenital adrenal hyperplasia (CAH1. Aim of the Study: To analyze the growth pattern of patients treated for CAH of the salt wasting (SW) and simple virilizing (SV) clinical forms; to evaluate final height as compared to reference data and individual target height; to evaluate the course of BA development. Patients and Methods: A large database of 598 patients with CAH was created in 5 Central European countries and growth data of 341 treated patients with 21-hydroxylase deficiency were analyzed retrospectively. The patients were of Caucasian origin. Centiles were constructed in a cross-sec tional manner and an additional longitudinal analysis was performed in order to evaluate the pubertal growth spurt by applying particular statistical methods (PreeceBaines model). Results: The growth of SW CAH patients was impaired in infancy and early childhood (0-3 years of age), but followed normal patterns in childhood until puberty. In contrast, children with SV CAH had normal patterns of growth in infancy and early childhood and were considerably taller than healthy references during childhood. In the longitudinal study, peak height velocity in both boys and girls was normal, but it occurred at an earlier age than in the standard population. The final height of patients with CAH was reduced in comparison to both the reference and the individual target height. No correlations were found between final height and age at the start of the therapy in SV patients or between final height and year of birth. BA was advanced in both types of CAH, but more accelerated in SV patients. Conclusion: Characteristic growth patterns for treated SV and SW CAH children were identified, with a normal pubertal growth spurt and reduced final height being observed.
Descriptors     ADRENAL HYPERPLASIA, CONGENITAL
STEROID 21-MONOOXYGENASE
BODY HEIGHT
GROWTH DISORDERS
AGE FACTORS
SEX FACTORS
PUBERTY
RETROSPECTIVE STUDIES