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Evaluation of impact of steroid replacement treatment on bone health in children with 21-hydroxylase deficiency.
[congenital adrenal hyperplasia]
There
are
conflicting
data
regarding
the
potential
impact
of
chronic
glucocorticoid
(
GC
)
therapy
on
the
bone
mineral
density
of
patients
with
congenital
adrenal
hyperplasia
(
CAH
)
.
Previous
studies
performed
by
dual-energy
X-
ray
absorptiometry
reported
conflicting
results
.
The
purpose
of
this
study
was
to
assess
the
impact
of
chronic
GC
replacement
treatment
in
children
with
classical
and
non
classical
CAH
due
to
21
-
hydroxylase
deficiency
(
21
-
OHD
)
by
quantitative
ultrasonometry
(
QUS
)
,
an
easy
,
cheap
,
and
radiation-free
technique
.
The
study
population
consisted
of
nineteen
21
-
OHD
patients
(
nine
males
)
on
lifelong
GC
treatment
.
Anthropometric
,
hormonal
,
and
treatment
data
were
recorded
for
each
patient
,
and
bone
quality
was
assessed
by
QUS
measurements
.
QUS
findings
(
amplitude-dependent
speed
of
sound
and
bone
transmission
time
)
were
normal
in
21
-
OHD
patients
and
did
not
correlate
with
duration
of
treatment
,
daily
,
total
,
and
yearly
hydrocortisone
dose
.
Furthermore
,
no
significant
correlation
was
found
between
QUS
findings
and
17
α-hydroxy
progesterone
,
Δ
4
-
androstenedione
,
and
Â
testosterone
levels
.
In
conclusion
,
our
results
provide
reassurance
that
currently
used
replacement
doses
of
GC
do
not
have
a
major
impact
on
bone
in
patients
with
CAH
.
QUS
seems
to
be
a
reliable
tool
for
screening
of
bone
health
in
children
with
21
-
OHD
.
Diseases
Validation
Diseases presenting
"bone mineral density"
symptom
achondroplasia
adrenal incidentaloma
allergic bronchopulmonary aspergillosis
aromatase deficiency
congenital adrenal hyperplasia
cushing syndrome
dentinogenesis imperfecta
erythropoietic protoporphyria
fabry disease
familial hypocalciuric hypercalcemia
familial mediterranean fever
kallmann syndrome
lamellar ichthyosis
phenylketonuria
primary hyperoxaluria type 1
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