Effect of glucocorticoids treatment on anthropometric parameters and sexual maturation rating in salt wasting and simple virilizing forms of congenital adrenal hyperplasia in Pakistani boys

Maleeha Akram; Madiha Shahbaz; Misbah Riaz; Shaista Aslam; Gulben Shahid; Mazhar Qayyum; Afzaal Ahmed Naseem; Fahim Tahir; S S R Rizvi

doi:10.1530/endoabs.32.P42

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Endocrine Abstracts (2013) 32 P42 | DOI: 10.1530/endoabs.32.P42

ECE2013 Poster Presentations Adrenal cortex (64 abstracts)

Effect of glucocorticoids treatment on anthropometric parameters and sexual maturation rating in salt wasting and simple virilizing forms of congenital adrenal hyperplasia in Pakistani boys

Maleeha Akram ¹ , Madiha Shahbaz ¹ , Misbah Riaz ¹ , Shaista Aslam ² , Gulben Shahid ³ , Mazhar Qayyum ¹ , Afzaal Ahmed Naseem ¹ , Fahim Tahir ⁴ & S S R Rizvi ^1,

Err

Author affiliations

¹Department of Zoology, PMAS Arid Agriculture University, Rawalpindi, Pakistan; ²Department of Zoology, Government College University, Lahore, Pakistan; ³Pakistan Institute of Sciences (PIMS), Children Hospital, Islamabad, Pakistan; ⁴Department of Reproductive Physiology, National Institute of Health, Islamabad, Pakistan; ⁵Pakistan Science Foundation, Islamabad, Pakistan.

Congenital adrenal hyperplasia (CAH), caused by lack of 21-hydroxylase, impairs cortisol secretion, which increases ACTH release that results in hyperplasia of adrenal glands and increased secretion of adrenal androgens. Elevated androgen concentration leads to increased skeletal maturation, early pubertal development and diminished pubertal growth. Treatment with glucocorticoids averts early puberty but may abruptly slow down growth. The effect of exogenous glucocorticoids on adrenal and kidney functions, anthropometric parameters and sexual maturation rating was examined. Based on chronological age, twenty three (14 salt wasting (SW) and 9 simple virilizing (SV) types) male CAH patients were divided into group-I (2 patients of <1 year), group-II (4 patients of 1–2 years), group-III (15 patients of 3–8 year) and group-IV (2 patients of 9–11 years). SW types were treated with hydrocortisone twice a day (20 mg in the morning and 10 mg at night) along with a single dose of florine F (0.1 mg), whereas SV patients were treated with hydrocortisone twice a day (20 mg in the morning and 10 mg at night). CAH patients were compared with normal age matched controls (20 boys/group) before and following treatment. Regardless of age group and type of CAH, 17-OH P concentrations significantly decreased, concentrations of creatinine and urea were normalized but rennin activity remained unaffected in all patients. Concentrations of sodium and potassium were normalized in SW form, whereas cortisol concentrations were higher in SV and depressed in SW type. Concentrations of LH remained low but those of T were higher in most patients. Height and weight were normalized, whereas bone age remained advanced in all patients. Penile length remained larger, testicular volume was higher and pubic hair was advanced in all patients. In conclusion, appropriate glucocorticoids doses restored adrenal and kidney functions, normalized most of anthropometric parameters but did not affect sexual maturation rating.