Growth pattern and final height in congenital adrenal hyperplasia

Kim, Ho Seong; Kim, Duk Hi

Abstract

Clinical characteristics and growth pattern were evaluated in 42 patients with classical congenital adrenal hyperplasia treated since diagnosis. And final height was evaluated in 16 patients who had reached final adult height with regard to clincal form, degree of hormonal control, and age of initial treatment. The results were as follows; 1) Among 42 patients with classical congenital adrenal hyperplasia, the male to female sex ratio was 1:1.8 (15 males and 27 females), and the frequency of the salt-wasting form (SW) and simple virilizing form (SV) was same (21 SW and 21 SV). 2) The length of time to initial treatment averated 4.2 months (range: 9 days-49 months) for salt-wasting form and 8.8 years (range: 1 month-21 years) for simple virilizing form. 3) In seven cases, precocious puberty developed during treatment and the average age on development was 6.8 years for salt-wasting form and 5.4 years for simple virilzing form. 4) The pattern of growth from birth throughout childhood in salt-wasting patients showed poor growth initially. The average height in simple virilizing patients was above the mean in the first years of life, declining steadily (falling below the mean by age 12), until the end of the growt period. 5) Bone ages were retarded initially in salt-wasting patients, thereafter accelerating by age 3, meanwhile in simple virilizing patients advanced initially. 6) In 16 patients who had reached final adult height, analysis of final height with regard to clinical form, degree of hormonal control, and age of initial treatment indicated that neither of them seem to after the height outcome. In conclusion, classical congenital adrenal hyperplasia patients seem to achieve final height consistently below the mean for the general population. Factors to affect the height outcome (clinical form, degree of hormonal control, age of initial treatment) may influence concomitently, and another factor may be present.