Study of Physical Functioning in Children with Congenital Adrenal Hyperplasia
Journal Title: INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY - Year 2017, Vol 5, Issue 4
Abstract
Background: Congenital adrenal hyperplasia (CAH) is an autosomal recessive disorder causing deficiency of enzymes involved in adrenal steroidogenesis. Steroid replacement therapy plays a vital role in the treatment. Hyperandrogenism due to the accumulation of intermediate metabolites is the important cause of symptoms. These hormonal imbalances would result in growth abnormalities and hence should be monitored stringently. Aims and Objectives: The aim of this study is to study the physical functioning in children with CAH on treatment and to compare simple virilizers and salt wasters. Materials and Methods: A total of 55 children between 2 and 12 years of age who met the inclusion and exclusion criteria were enrolled in the study. Detailed history, anthropometry, body mass index (BMI), blood pressure, X-ray for bone age, and 17-hydroxy progesterone levels were obtained. Observation and Results: In our study, 82% (n = 45) were females and only 18% (n = 10) were males. CAH in males has been under diagnosed in our population. As expected salt-wasting type constituted the majority about 62% (n = 34). Simple virilizing type was only 38% (n = 21). Mean dose of steroid administered to our patients in this study is 16.3 ± 4.4 mg/m2 body surface area. Mean height z-score in our study was −0.2±2.1. About 67% (n = 37) of the total population had their height z-scores between −2 and +2. About 11% (n = 6) of them were >+3 z- score and 9% (n = 5) of them were <-3 z-score. Among the patients with height z-scores >+3 z-score, 5 patients were on recommended dose. 47% (n = 26) of our patients had normal BMI. 20% (n = 11) of them were obese while 18% (n = 10) of them were overweight. Conclusion: 20% of the total study population had abnormal growth profile, and 53% of the kids had abnormal BMI due to infrequent monitoring. Hence, frequent monitoring of height, weight, and BMI is essential for all patients with CAH irrespective of the type of disease. Based on the clinical findings and hormonal assays, individualized dosage modification should be done regularly.
Authors and Affiliations
C Rekha, R Paramaguru, Vimala Sarojini, Dr Seenivasan
Keywords
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