Abstract
Chronic exposure to sex steroids during childhood accelerates skeletal maturation and may compromise final height. The growth of 26 children (18 girls, 8 boys) disease-free of ACC for more than 1 yr were reviewed. The initial clinical signs appeared at 2.9 ± 2.8 yr and the diagnosis was made at 3.6 ± 2.8 yr. Time of follow-up after surgery was 6.2 ± 3.5 yr (range 1.5 - 13.0). 50% had adrenogenital syndrome (AS), 38% mixed syndrome (MS: Cushing's plus AS), 8% no endocrine symptoms and 4% Cashing syndrome. At the time of diagnosis the mean H-SDS was higher than target height-SDS (TH-SDS; p < 0.0001). H-SDS was not different between AS and MS groups (p > 0.1). Bone age (BA; 6.2 ±3.6) was greater than height age (HA; 4.2 ± 2.7) and chronological age (CA; 3.8 ± 2.9) (p < 0.05), whereas HA and CA were not different. BA advanced more than CA in the 1st year following tumor removal; in the 2nd year and thereafter we observed catch-down growth that was more intense in BA than in H-SDS. Only one patient of the series, with no BA catch-down, developed true precocious puberty. Initial predicted adult height (PAH; Bay ley & Pinneau) of 10 patients was lower than target height (TH; p < 0.01); however, in the last evaluation (16 pts) PAH and TH were not different (p > 0.1). In conclusion: a) children exposed to androgen with/without glucocorticoid for a limited period of time usually increase BA more than H-SDS; b) after tumor excision both BA and H-SDS exhibit catch-down growth that is more pronounced for BA; c) despite the initial advancement of BA it appears that the final height is not compromised.
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Schmit-Lobe, M., De Lacerda, L., Ribeiro, R. et al. PATTERNS OF GROWTH AND DEVELOPMENT IN 26 CHILDREN OPERATED FOR ADRENOCORTICAL CARCINOMA (ACC) AND DISEASE-FREE FOR MORE THAN ONE YEAR. Pediatr Res 38, 622 (1995). https://doi.org/10.1203/00006450-199510000-00029
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DOI: https://doi.org/10.1203/00006450-199510000-00029