Final Height in Patients with Congenital Adrenal Hyperplasia: The Controversy of Under Treatment Versus Overtreatment

Abstract Background: Growth patterns in congenital adrenal hyper-plasia (CAH) are challenging. Androgen excess can occur at any age leading to accelerated growth, early epiphyseal closure and compromised final height (FH). The FH in CAH is usually expected to be lower than predicted based on parental height or compared to the healthy population. Aim of Study: To evaluate growth and FH in patients with CAH. Patients and Methods: This retrospective study included 34 patients diagnosed with classic CAH (27 salt wasting and 7 simple virilizing). An anthropometric assessment was done for the patients and their parents to estimate the FH, target height (TH) and corrected FH (FH – TH). Therapeutic and biochemi-cal data were obtained from their clinical records. Results: FH and FH SDS were 161.35±6.56cm; -1.74 SD and 151.16cm; -1.46 SD in males and females respectively. FH showed more than 5cm reduction compared to TH (p<0.05). However, there was no significant difference between the cor-rected FH SDS and TH SDS in both sexes (p>0.05). Patients with SV CAH had worse FH and TH as well as their SDSs (p<0.05). Males with earlier onset of puberty had reduced FH (p<0.05). Mean androgen levels and glucocorticoid doses did not significantly impair FH in our patients (p>0.05). Conclusion: The corrected FH of our CAH patients, de-spite being lower than the normal population, was appropriate to their TH. FH was influenced by genetic potential in both sex-es as well as onset of puberty in males.