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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 in patients"
symptom
congenital adrenal hyperplasia
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