Hydrocortisone therapy and growth trajectory in children with classical congenital adrenal hyperplasia

ABSTRACT Objective: Poor linear growth is one of the main concerns in children with congenital adrenal hyperplasia (CAH). We aimed to analyze factors affecting growth trajectory in children with classical CAH. Methods: Clinical records of children followed from infancy up to the end of growth at two Italian tertiary referral hospitals were reviewed. Fifty-seven patients (31 males), treated with hydrocortisone and fludrocortisone only, were included. Clinical observations were divided into three groups: 0 to 2 years, 172 observations; from 2 years to puberty onset, 813 observations; after puberty onset, 527 observations. Height velocity, pubertal growth spurt, and final height were evaluated as outcomes. Results: Final height standard deviation score (SDS) was lower than target height SDS (−0.74 ± 1.1 versus −0.31 ± 1.01; P<.001). Target-adjusted final height SDS was −0.44 ± 1.8 in males and −0.13 ± 1.1 in females (P = .001). Total pubertal growth was 21.9 ± 7.3 cm in males and 19.2 ± 8.2 cm in females (P ...