Abnormal linear growth in paediatric adrenal diseases: Pathogenesis,prevalence and management |
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| Authors: | Marianna Minnetti Silvana Caiulo Rosario Ferrigno Barbara Baldini-Ferroli Giorgia Bottaro Daniele Gianfrilli Emilia Sbardella Maria Cristina De Martino Martin O. Savage |
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| Affiliation: | 1. Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy;2. Department of Pediatrics, IRCCS San Raffaele Hospital, Milan, Italy;3. Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Naples, Italy;4. Dipartimento Pediatrico Universitario Ospedaliero, Bambino Gesu' Children's Hospital, Rome, Italy;5. Endocrinology Centre, William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, London, UK |
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| Abstract: | ![]()
Abnormal adrenal function can interfere with linear growth, potentially causing either acceleration or impairment of growth in paediatric patients. These abnormalities can be caused by direct effects of adrenal hormones, particularly glucocorticoids and sex steroids, or be mediated by indirect mechanisms such as the disturbance of the growth hormone-insulin-like growth factor-1 axis and aromatization of androgens to oestrogens. The early diagnosis and optimal treatment of adrenal disorders can prevent or minimize growth disturbance and facilitate improved height gain. Mechanisms of growth disturbance in the following abnormal states will be discussed; hypercortisolaemia, hyperandrogenaemia and obesity. Prevalence and features of growth disturbance will be discussed in ACTH-dependent and ACTH-independent Cushing's syndrome, adrenocortical tumours, premature adrenarche, congenital adrenal hyperplasia and adrenal insufficiency disorders. Recommendations for management have been included. |
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| Keywords: | adrenal disorders adult height growth plate height hyperandrogenism hypercortisolaemia paediatric |
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