Scientific article

Should we monitor more closely the dosage of 9 alpha-fluorohydrocortisone in salt-losing congenital adrenal hyperplasia?

Published inJournal of pediatric endocrinology & metabolism, vol. 11, no. 6, p. 733-737
Publication date1998

In salt-losing congenital adrenal hyperplasia (CAH), continuous therapy with glucocorticoids and 9 alpha-fluorohydrocortisone (9 alpha-F) remains the golden rule. Previous reports showed a growth promoting effect of 9 alpha-F therapy. In addition, 9 alpha-F seemed to have a negligible glucocorticoid action. To confirm these facts, we analyzed the clinical data and the biological markers of control of therapy in two groups of patients with salt-losing CAH aged from 2 to 12 years: group I: before (time 0) and 6 months after the increase in 9 alpha-F dosage (time +6); group II: at time 0 and time +6 but without change in 9 alpha-F dosage. Groups were similar in terms of mean age, bone age and hydrocortisone dose. The mean dose of 9 alpha-F was 68.2 +/- 5.0 micrograms/m2/d at time 0 and was increased to 98.6 +/- 7.7 micrograms/m2/d at time +6 in group I; it remained similar in group II. In group I, height velocity decreased significantly from 8.1 +/- 0.6 at time 0 to 6.3 +/- 0.3 cm/yr at time +6 (p < 0.01) while in group II there was no significant change. In group I, plasma renin activity decreased from 10.4 +/- 1.6 at time 0 to 3.9 +/- 1.1 ng/ml/h at time +6 (p < 0.005) and showed no change in group II. These preliminary results suggest that careful monitoring of 9 alpha-F is essential to control a proper growth rate.

  • Adrenal Hyperplasia, Congenital/drug therapy/metabolism/pathology
  • Body Height/drug effects
  • Child
  • Child, Preschool
  • Dose-Response Relationship, Drug
  • Drug Monitoring
  • Female
  • Fludrocortisone/administration & dosage/therapeutic use
  • Hormones/blood
  • Humans
  • Male
  • Mineralocorticoids/administration & dosage/therapeutic use
  • Sodium Chloride/metabolism
  • Treatment Outcome
Citation (ISO format)
AFONSO LOPES-PIMENTA, Maria De Lurdes et al. Should we monitor more closely the dosage of 9 alpha-fluorohydrocortisone in salt-losing congenital adrenal hyperplasia? In: Journal of pediatric endocrinology & metabolism, 1998, vol. 11, n° 6, p. 733–737. doi: 10.1515/jpem.1998.11.6.733
Main files (1)
Article (Published version)
ISSN of the journal0334-018X

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