Evaluation of subclinical cardiac complications in children with congenital adrenal hyperplasia

Background Congenital adrenal hyperplasia (CAH) is an autosomal recessive illness primarily due to 21-hydroxylase deficiency, leading to glucocorticoid and mineralocorticoid deficiencies and androgen excess. This predisposes children to cardiac risks, including left ventricular dysfunction, obesity, hypertension, and insulin resistance, stemming from hormonal imbalances and treatment effects. Aim To assess subclinical cardiac complications in children with CAH. Patients and methods This cross-sectional research was conducted at the Pediatric Department, Tanta University Hospital, from May 2023 to 2024. This research involved 20 cases diagnosed with CAH (group A) and 20 healthy children as control (group B). Results Groups were similar in age and sex. CAH patients had significantly lower height SD score (–1.25 vs. 0.19, P <0.001), higher BMI SD score (0.42 vs. −0.08, P =0.027), lower sodium (136.78 vs. 140.80 mmol/l, P <0.001), lower potassium (4.16 vs. 4.64 mmol/l, P <0.001), elevated 17-hydroxyprogesterone (6.63 vs. 0.4 ng/ml, P =0.001) and androstenedione (2.49 vs. 0.27 ng/ml, P= 0.032). Echocardiography showed reduced left ventricular internal diameter in systolic (2.27 vs. 2.55 cm, P =0.01) and E/A ratio (1.57 vs. 1.83, P =0.025). Insignificant variances in ejection fraction, fractional shortening, or blood pressure. Conclusion CAH children exhibit early cardiac alterations, including impaired diastolic function and highlighting the need for routine screening to mitigate long-term risks.