Adrenomedullary Function in Cohort of Brazilian Pediatric Patients with Classic Congenital Adrenal Hyperplasia

Talita Soriano Cruz Hovland, Izabel Calland Ricarte Beserra
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Abstract

Congenital Adrenal Hyperplasia is a group of autosomal recessive disorders resulting from deficiency of enzymes essential for the synthesis of cortisol. Disease of the adrenal cortex, but there may be involvement adrenomedullary. Cortisol and epinephrine are directly related to the individual’s stress response. Lower values of epinephrine in children with congenital adrenal yperplasia could be related to increased clinical complications and hospitalizations rate. We evaluated the serum values of metanephrines and normetanephrines in children and adolescents with classic congenital adrenal hyperplasia and primary hypothyroidism and possible correlations with disease and hospitalizations. Cross-sectional study involved 29 patients (10 simple virilizing and 19 salt-wasting), and control group of 28 patients with primary hypothyroidism (10 overt and 18 subclinical). There were no differences in age (p = 0.24) and metanephrine (p = 0.34) or normetanephrine values (p = 0.85) between groups.Hospitalization rate was higher in the cases than in the controls (51 x 12).We conclude the serum values of metanephrine and normetanephrine in patients with congenital adrenal hyperplasia were within the normal values of reference, with no significant difference of group with primary hypothiroidism. The number of hospitalizations in the case was high in relation to the control, mainly in salt-wasting.
典型先天性肾上腺增生的巴西儿童队列的肾上腺髓功能
先天性肾上腺增生症是一组常染色体隐性遗传病,由缺乏合成皮质醇所必需的酶引起。肾上腺皮质疾病,但也可能累及肾上腺髓质。皮质醇和肾上腺素与个体的应激反应直接相关。先天性肾上腺增生儿童肾上腺素水平较低可能与临床并发症和住院率增加有关。我们评估了典型先天性肾上腺增生和原发性甲状腺功能减退的儿童和青少年的血清肾上腺素和去甲肾上腺素的值,以及与疾病和住院治疗的可能相关性。横断面研究纳入29例患者(单纯男性化10例,盐耗19例),对照组28例原发性甲状腺功能减退(10例明显,18例亚临床)。各组患者年龄(p = 0.24)、肾上腺素(p = 0.34)和去甲肾上腺素(p = 0.85)差异无统计学意义。病例住院率高于对照组(51 x 12)。结论先天性肾上腺增生患者血清中肾上腺素和去甲肾上腺素均在正常参考值范围内,原发性甲状腺功能减退组间差异无统计学意义。与对照组相比,该病例的住院人数较高,主要是盐消耗。
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