Abnormal linear growth in paediatric adrenal diseases: Pathogenesis, prevalence and management

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 mecha...

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Bibliographic Details
Published in:Clinical endocrinology (Oxford) 2020-02, Vol.92 (2), p.98-108
Main Authors: Minnetti, Marianna, Caiulo, Silvana, Ferrigno, Rosario, Baldini‐Ferroli, Barbara, Bottaro, Giorgia, Gianfrilli, Daniele, Sbardella, Emilia, De Martino, Maria Cristina, Savage, Martin O.
Format: Article
Language:English
Subjects:
adrenal disorders
Adrenal Gland Diseases - complications
Adrenal Gland Diseases - epidemiology
Adrenal Gland Diseases - therapy
Adrenal glands
Adrenocorticotropic hormone
adult height
Age of Onset
Androgens
Body Height - physiology
Child
Child Development - physiology
Cushing syndrome
Endocrinology - standards
Endocrinology - trends
Estrogens
Glucocorticoids
Growth Disorders - epidemiology
Growth Disorders - etiology
Growth Disorders - therapy
Growth hormones
growth plate
height
Humans
hyperandrogenism
hypercortisolaemia
Hyperplasia
Insulin
Nervous system diseases
paediatric
Pediatrics - standards
Pediatrics - trends
Pituitary
Practice Guidelines as Topic
Prevalence
Steroid hormones
Tumors
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Summary: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.
ISSN:0300-0664
1365-2265
DOI:10.1111/cen.14131