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Absence of clinically relevant growth acceleration in untreated children with non-classical congenital adrenal

Karijn J Pijnenburg-Kleizen1, George F Borm, Barto J Otten

  • 1Department of Paediatric Endocrinology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands. K.Kleizen@cukz.umcn.nl

Hormone Research in Paediatrics
|April 18, 2012
PubMed

Insights

Growth acceleration in children with non-classical congenital adrenal hyperplasia (NC-CAH) is minimal. Bone age acceleration is more significant, indicating NC-CAH may be present even without obvious growth spurts.

Area of Science:

  • Pediatric Endocrinology
  • Genetics and Genetic Diseases
  • Metabolic Disorders

Background:

  • Congenital adrenal hyperplasia (CAH) involves elevated adrenal androgens, impacting growth and bone maturation.
  • Non-classical CAH (NC-CAH) presents with milder androgen excess, potentially leading to subtle growth velocity changes in untreated children.

Purpose of the Study:

  • To investigate growth patterns and bone maturation in untreated children with non-classical CAH (NC-CAH).
  • To determine if subtle growth changes in NC-CAH warrant further diagnostic consideration.

Main Methods:

  • Twenty-four untreated NC-CAH patients were categorized into symptomatic and asymptomatic groups.
  • Height standard deviation scores (HSDS) corrected for target height (HSDS-THSDS) and bone age acceleration (BA(c)) were analyzed.
  • Linear mixed models were employed to assess growth and bone age parameters.

Main Results:

  • Symptomatic NC-CAH patients showed a slight annual increase in HSDS-THSDS (0.06 SDS/year).
  • Mean bone age acceleration (BA(c)) in symptomatic patients was 2.21 years (SDS 0.66, p < 0.0001).
  • Asymptomatic NC-CAH patients exhibited no significant growth acceleration or BA(c).

Conclusions:

  • Growth acceleration in untreated NC-CAH children is often subtle and may not be apparent on standard growth charts.
  • Bone age acceleration (BA(c)) is a more pronounced indicator in NC-CAH.
  • The absence of increased growth velocity does not rule out NC-CAH; bone age assessment is crucial for diagnosis.
Abstract

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