Cardiovascular risk factors and increased carotid intima-media thickness in young patients with congenital adrenal hyperplasia due to 21-hydroxylase deficiency

Rodrigues, Tânia Maria Barreto; Barra, Cristina Botelho; Santos, Jósé Lúcio dos; Goulart, Eugênio Marcos Andrade; Ferreira, Adaliene Versiani Matos; Silva, Ivani Novato

doi:10.1590/2359-3997000000119

Cited by 20 publications

(20 citation statements)

References 34 publications

(44 reference statements)

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“…The average age at diagnosis was greater than that of Rodrigues and al (2 months) [21]. Awareness of medical teams concerning abnormal genitalia is greater in Latin America, explaining the present difference.…”

Section: Discussionmentioning

confidence: 56%

“…Sowande and al in 2009 in Nigeria, in their retrospective study on disorders of sexual differentiation, had 6 cases attributed to the CAH and all had as a dominant clinical presentation, clitoromegaly [20]. The average age at diagnosis was greater than that of Rodrigues and al (2 months) [21]. Awareness of medical teams concerning abnormal genitalia is greater in Latin America, explaining the present difference.…”

Section: Discussionmentioning

confidence: 90%

“…Sex rearing proportion was 26.31% (5/19) boys and 73.68% (14/19) girls, and after the karyotype, boys represented 5.26% (1/19). These gender assignment errors were found by Rodrigues and al in 20% of cases in Brazil in 2015 [21], in 30% by Sowande and al in Nigeria in 2009 [20]. In Sudan, Abdullah and al in 2011 [22] in a retrospective study over 5 years involving 122 children, had a higher prevalence of female gender after completion of the karyotype and 19% had to change sex with a preference for males.…”

Section: Discussionmentioning

confidence: 97%

“…Moreover, the deficit type involved (11-β OH) has a mineralocorticoid effect by the accumulation of 11-deoxycorticosterone [25, 32]. The likely involvement of treatment with glucocorticoids, resulting in a compromise between the advantages and disadvantages [21]. In 2014, AMR and al in Egypt have shown a rise in cardiovascular risk in CAH patients, but no correlation was found between the different variables and the average daily dose of hydrocortisone.…”

Section: Discussionmentioning

confidence: 99%

“…In 2014, AMR and al in Egypt have shown a rise in cardiovascular risk in CAH patients, but no correlation was found between the different variables and the average daily dose of hydrocortisone. The hypothesis of a cumulative effect of steroid treatment over the years was issued [21, 33]. But our study population is young and treated with doses according to recommendations [1, 25].…”

Section: Discussionmentioning

confidence: 99%

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Assessment of cardiac function in children with congenital adrenal hyperplasia: a case control study in Cameroon

Nengom

Chelo

et al. 2017

BMC Pediatr

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BackgroundHigh level of androgens found in congenital adrenal hyperplasia (CAH) seems to have a deleterious effect on heart function. We therefore evaluate cardiac function of children with CAH in comparison with a healthy group.MethodsWe carried out a case-control study in the single endocrinology unit of the Mother and Child Center of Chantal Biya’s Foundation. Cases were matched for age and genotypic sex to 2 healthy controls. We analyzed the ejection fraction (LVEF), fractional shortening and left ventricular mass; output and cardiac index; E and A waves velocities, E/A ratio and the mitral deceleration time and diameter of the left atrium; tricuspid annular plane systolic excursion and pulmonary artery systolic pressure were also measured.ResultsWe included 19 patients with a median age of 6.26 ± 3.75 years and 38 controls stackable distribution. The left ventricular mass of cases was greater than that of controls. A case of reversible cardiomyopathy on hormone replacement therapy was found.For the cases, the average ejection fraction was 71.95 ± 7.88%; the average fractional shortening was 40.67 ± 7.02%. All these values were higher than those of controls, although the difference was not statistically significant. Diastolic left ventricular function was more impaired among the cases.Right ventricular function was similar in both groups. These abnormalities were highly correlated to the late age at diagnosis and duration of treatment.ConclusionThis study shows an altered cardiac function in CAH compared to healthy control and highlights importance of an early diagnosis of cases, a tight control of androgens levels and a regular monitoring of cardiac function.

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Section: Discussionmentioning

confidence: 56%

Section: Discussionmentioning

confidence: 90%