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Linear Growth and Growth Hormonal Responsiveness in Treated Congenital Adrenal Hyperplasia

Mark A. Sperling, MB, BS, MRACP; Frederick M. Kenny, MD; Joseph C. Schutt-Aine, MD; Allan L. Drash, MD
Am J Dis Child. 1971;122(5):408-413. doi:10.1001/archpedi.1971.02110050078008.
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An analysis of the growth patterns of 30 children with congenital adrenal hyperplasia (CAH) treated with cortisone acetate revealed 76% to be at or below the third percentile by age 2 years. Paradoxically, the growth rate was better in the first six months of life when the dose of cortisone per unit of body surface was highest. Among this group of 30 children, a sample of six children receiving therapy intramuscularly showed no significant difference in their growth hormone response to arginine hydrochloride or insulin stimulation when compared with a group of normal children. These data are consistent with an antagonism by cortisone of the actions of growth hormone at the peripheral level rather than a central inhibition of growth hormone release. In addition, linear growth in the first 6 months of life seems relatively independent of the growth suppressing effects of glucocorticoids.

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