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Sexual difference in bone geometry of adult patients with classical congenital adrenal hyperplasia: data using peripheral quantitative computed tomography.
[congenital adrenal hyperplasia]
Glucocorticoid
treatment
may
influence
bone
and
muscle
development
in
patients
with
congenital
adrenal
hyperplasia
(
CAH
)
.
This
study
evaluated
bone
mineral
density
(
BMD
)
,
bone
geometry
and
muscle
mass
.
73
adult
patients
with
classical
CAH
were
followed
.
BMD
,
bone
geometry
and
muscle
mass
were
measured
using
peripheral
quantitative
computed
tomography
(
pQCT
)
.
Glucocorticoid-equivalent
doses
throughout
life
were
calculated
and
at
the
time
pQCT
androgen
levels
were
measured
.
In
males
the
mean
standard
deviation
(
SD
)
score
for
trabecular
BMD
(
-
0
.
33
±
0
.
71
)
was
reduced
,
whereas
mean
cortical
BMD
(
1
.
05
±
1
.
11
)
was
elevated
.
Mean
total
(
0
.
86
±
1
.
12
)
and
medullary
cross-sectional
area
(
CSA
;
1
.
12
±
1
.
17
)
were
significantly
increased
(
p
<
0
.
001
)
.
In
all
patients
SD
scores
for
cortical
thickness
(
-
0
.
65
±
0
.
91
)
and
muscle
CSA
(
-
0
.
83
±
0
.
91
)
were
reduced
.
Treatment
duration
was
associated
with
lower
trabecular
BMD
in
males
(
r
=
-
0
.
63
,
p
<
0
.
001
)
.
Suppressed
androgens
and
simple
virilizing
CAH
had
an
adverse
effect
on
the
muscle
CSA
SD
score
(
OR
0
.
58
and
0
.
46
,
respectively
,
p
<
0
.
05
)
.
There
was
a
sexual
difference
with
enlarged
total
and
medullary
CSA
in
females
,
whereas
in
males
trabecular
BMD
was
reduced
and
cortical
BMD
elevated
.
Cortical
thickness
and
muscle
CSA
were
reduced
in
all
CAH
patients
with
a
possible
long
-term
impact
on
bone
development
and
stability
.
Monitoring
of
bone
and
muscle
development
might
be
warranted
.
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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