The outcome of height in a cohort of children with congenital adrenal hyperplasia: a preliminary report from Sri Lanka

Introduction: Adequate replacement therapy with hydrocortisone is essential in congenital adrenal hyperplasia to achieve satisfactory growth in height and age appropriate skeletal maturity. Our objectives were to assess the heights of a cohort of children with CAH in relation to the standard dosage of hydrocortisone and duration of therapy.

 Method: Clinical data of 22 patients followed up at the University Paediatric Unit at the Lady Ridgeway Hospital, Colombo were documented using an interviewer administered questionnaire. Their heights after completion of 1, 4 and 7 years of therapy were recorded with the corresponding dose of hydrocortisone and bone age. Height standard deviation scores (SDS) were calculated for each patient and the mean (SD) values in the 3 groups of patients.

Results: Fifteen (68.2%) were girls and 20 (90.9%) had the salt-wasting form of CAH. After completion of 1, 4 and 7 years of treatment, the height SDS ranged from (-3.16 to 2.12), (-2.9 to 2.92) and (-1.65 to 1.74) with mean (SD) of -0.59 (1.39), -0.2 (1.37) and -0.08 (0.98) respectively. The corresponding mean (SD) hydrocortisone doses (mg/m2/day) were 12.19 (4.62), 11.53 (3.61) and 11.01 (2.77). The bone age advancement reduced over time. Nineteen out of 22 (86.4%) and all 13 were in the normal height SDS range (-2SD to +2SD) after 1 and 7 years of treatment respectively.