Introduction: In children with congenital adrenal hyperplasia (CAH), central precocious puberty (CPP) may occur and this situation may compromise final height. We aimed to evaluate the effect of GnRH analog therapy (GnRHa-T) on growth in children with CAH.
Design: Ten children with CAH were included in ongoing follow-up study. Nine children underwent GnRH stimulation test. GnRHa-T was used as 3.75 mg/q 4 weeks and the dose had to be increased to 7.5 mg/q 4 weeks in two children. Bone ages (BA), growth velocities (GV) and BMIs of patients during treatment were evaluated.
Results: On admission mean chronologic age (CA) and BA were 6.18±2.1 years and 10.5±2 years respectively. Five children have 46,XX karyotype, but one of them was reared as a male. Mean follow-up 4±1.8 years. A significant difference was found between mean BA/CA on admission and at last visit (P=0.002; t: 4933), and between mean BA/CA the beginning of GnRHa-T and at last visit (P=0.002; t: 4453). Mean CA was significantly increased in girls than boys at the beginning of GnRHa-T (8.37±0.9 vs 5.2±1.5 years; P=0.032).
GV was 5.96±2.2, 6.98±2.9 and 4.77±2.8 cm at the end of first (GV1), second (GV2) and third years of the therapy respectively. BMI was inversely correlated with GV1 (r: −0.818; P=0.007) and GV2 (r: −0.731; P=0.039). Mean CA at the beginning of GnRHa-T was negatively correlated with GV1 (r: −0.714; P=0.047) and GV2 (r: −0.927; P=0.003).
|On admission||At the beginning of GnRHa therapy||At last visit on therapy|
|Mean chronologic age (CA; years)||6.18±2.1||6.78±1.8||10.1±2|
|Mean bone age (BA; years)||10.5±2||11.2±1.7||12.3±2.1|
|Mean predicted height (cm)||157.6±21||161.3±11|
Conclusion: GnRHa-T should be considered for augmentation of linear growth in children with CAH complicated with CPP, particularly in children with not too advanced BA for CA.
27 Apr - 01 May 2013
European Society of Endocrinology