Linear Growth and Growth Hormonal Responsiveness in Treated Congenital Adrenal Hyperplasia

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.