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Bone mineral density in children and adolescents with congenital adrenal hyperplasia.
[congenital adrenal hyperplasia]
Chronic
glucocorticoid
therapy
is
associated
with
reduced
bone
mineral
density
.
In
paediatric
patients
with
congenital
adrenal
hyperplasia
,
increased
levels
of
androgens
could
not
only
counteract
this
effect
,
but
could
also
advance
bone
age
,
with
interference
in
the
evaluation
of
densitometry
.
We
evaluate
bone
mineral
density
in
paediatric
patients
with
classic
congenital
adrenal
hyperplasia
taking
into
account
chronological
and
bone
ages
at
the
time
of
the
measurement
.
Patients
aged
between
5
and
19
years
underwent
radiography
of
the
hand
and
wrist
followed
by
total
body
and
lumbar
spine
densitometry
.
Chronological
and
bone
ages
were
used
in
the
scans
interpretation
.
In
fourteen
patients
,
mean
bone
mineral
density
Z-
score
of
total
body
to
bone
age
was
-
0
.
76
and
of
lumbar
spine
to
bone
age
was
-
0
.
26
,
lower
than
those
related
to
chronological
age
(
+
0
.
03
and
+
0
.
62
,
resp
.
)
.
Mean
Z-
score
differences
were
statistically
significant
(
P
=
0
.
004
for
total
body
and
P
=
0
.
003
for
lumbar
spine
)
.
One
patient
was
classified
as
having
low
bone
mineral
density
only
when
assessed
by
bone
age
.
We
conclude
that
there
was
a
reduction
in
the
bone
mineral
density
Z-
score
in
classic
congenital
adrenal
hyperplasia
paediatric
patients
when
bone
age
was
taken
into
account
instead
of
chronological
age
.
Diseases
Validation
Diseases presenting
"increased levels of androgens could not only counteract this effect"
symptom
congenital adrenal hyperplasia
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