Randomised controlled trial of growth effect of hydrocortisone in congenital adrenal hyperplasia

Randomised controlled trial of growth effect of hydrocortisone in congenital adrenal hyperplasia

Author Silva, Ivani Novato Google Scholar
Kater, Claudio Elias Autor UNIFESP Google Scholar
Cunha, Cristiane de Freitas Google Scholar
Viana, Marcos Borato Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Universidade Federal de Minas Gerais (UFMG)
Abstract The influence of 15 or 25 mg/m(2) of daily oral hydrocortisone with fludrocortisone 0.1 mg/day on growth and laboratory findings was evaluated in a prospective randomised crossover trial over 12 months in 26 children with 21-hydroxylase deficiency. Nine non-salt losers had fludrocortisone stopped for a further six month period. Height velocity was significantly decreased during treatment with 25 mg/m(2) as compared with 15 mg/m(2). This was the most sensitive indicator of corticosteroid treatment excess. A dose dependent effect upon plasma concentrations of 17-hydroxyprogesterone, testosterone, and androstenedione was found but increased values were still detected in more than half of the determinations made during the 25 mg/m(2) period. Height velocity and 17-hydroxyprogesterone concentrations were positively correlated. Growth hormone response to clonidine stimulation and insulin-like growth factor-1 concentrations were both within reference values and there was no difference between treatment periods. Withdrawal of fludrocortisone did not result in any difference for the non-salt losers. It was concluded that 25 mg/m(2) of hydrocortisone depressed growth in children with congenital adrenal hyperplasia, adn that full suppression, or even normalisation, of plasma concentrations of 17-hydroxyprogesterone and androgens should not be considered a treatment goal, but instead an indication of corticosteroid treatment excess.
Keywords Hydrocortisone
Congenital adrenal hyperplasia
Language English
Date 1997-09-01
Published in Archives Of Disease In Childhood. London: British Med Journal Publ Group, v. 77, n. 3, p. 214-218, 1997.
ISSN 0003-9888 (Sherpa/Romeo, impact factor)
Publisher British Med Journal Publ Group
Extent 214-218
Origin https://dx.doi.org/10.1136/adc.77.3.214
Access rights Open access Open Access
Type Article
Web of Science ID WOS:A1997XX93200008
URI https://repositorio.unifesp.br/11600/42644

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