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

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dc.contributor.authorSilva, Ivani Novato
dc.contributor.authorKater, Claudio Elias [UNIFESP]
dc.contributor.authorCunha, Cristiane de Freitas
dc.contributor.authorViana, Marcos Borato [UNIFESP]
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.contributor.institutionUniversidade Federal de Minas Gerais (UFMG)
dc.date.accessioned2018-06-15T13:56:00Z
dc.date.available2018-06-15T13:56:00Z
dc.date.issued1997-09-01
dc.description.abstractThe 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.en
dc.description.affiliationUNIV FED SAO PAULO,DEPT PEDIAT,SAO PAULO,BRAZIL
dc.description.affiliationUNIV FED SAO PAULO,DEPT MED,SAO PAULO,BRAZIL
dc.description.affiliationUNIV FED MINAS GERAIS,UNIT PAEDIAT ENDOCRINOL,BR-30130100 BELO HORIZONT,MG,BRAZIL
dc.description.affiliationUnifespUNIV FED SAO PAULO,DEPT PEDIAT,SAO PAULO,BRAZIL
dc.description.affiliationUnifespUNIV FED SAO PAULO,DEPT MED,SAO PAULO,BRAZIL
dc.description.sourceWeb of Science
dc.format.extent214-218
dc.identifierhttps://dx.doi.org/10.1136/adc.77.3.214
dc.identifier.citationArchives Of Disease In Childhood. London: British Med Journal Publ Group, v. 77, n. 3, p. 214-218, 1997.
dc.identifier.doi10.1136/adc.77.3.214
dc.identifier.issn0003-9888
dc.identifier.urihttps://repositorio.unifesp.br/handle/11600/42644
dc.identifier.wosWOS:A1997XX93200008
dc.language.isoeng
dc.publisherBritish Med Journal Publ Group
dc.relation.ispartofArchives Of Disease In Childhood
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectHydrocortisoneen
dc.subjectGrowthen
dc.subjectCongenital adrenal hyperplasiaen
dc.titleRandomised controlled trial of growth effect of hydrocortisone in congenital adrenal hyperplasiaen
dc.typeinfo:eu-repo/semantics/article
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