Author |
Silva, Ivani Novato
![]() Kater, Claudio Elias ![]() ![]() Cunha, Cristiane de Freitas ![]() Viana, Marcos Borato ![]() ![]() |
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
Growth 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 |
|
Access rights | Open access ![]() |
Type | Article |
Web of Science ID | WOS:A1997XX93200008 |
URI | https://repositorio.unifesp.br/11600/42644 |
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