Final height in congenital adrenal hyperplasia: the dilemma of hypercortisolism versus hyperandrogenism

• Autor(a) principal: Cordeiro, Giovana Vignoli
• Data de Publicação: 2013
• Outros Autores: Silva, Ivani Novato, Goulart, Eugênio Marcos Andrade, Chagas, Antônio José das, Kater, Claudio Elias [UNIFESP]
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Institucional da UNIFESP
• Texto Completo: http://dx.doi.org/10.1590/S0004-27302013000200005; http://repositorio.unifesp.br/handle/11600/7641
• topic: Congenital adrenal hyperplasia; steroid 21-hydroxylase; corticosteroids; hydrocortisone; body height; Hiperplasia suprarrenal congênita; esteroide 21-hidroxilase; corticosteroides; hidrocortisona; estatura

OBJECTIVE: The purpose of this study was to identify factors that might interfere with reaching the final height in patients with 21-hydroxylase deficiency (21-OHD). SUBJECTS AND METHODS: Thirty-one patients with classical 21-OHD who reached their FH in our Institution were eva­luated in order to compare the Z score for final height (FHZ) with: (1) the target height, (2) the standard height for the population, and (3) the hydrocortisone treatment schedule. RESULTS: The FHZ of -2.13 ± 1.11 had a significant negative correlation with the hydrocortisone doses used throughout the period of study. Patients who reached FH within the normal population range were those who received lower doses of hydrocortisone, as compared to those whose FH remained below -2 SDS. CONCLUSION: We conclude that careful treatment adjustments have a major influence on growth of children with CAH, and that the dose range for hydrocortisone replacement that does not lead to side effects is relatively narrow. The better height outcome was achieved in 21-OHD patients who received lower doses of hydrocortisone.