Childhood growth in boys with congenital hypogonadotropic hypogonadism

BACKGROUND: We describe childhood growth patterns in a series of well-characterized patients with congenital hypogonadotropic hypogonadism (CHH) with special emphasis on genotype-phenotype correlation.

METHODS: We retrospectively evaluated the growth charts of 36 males with CHH (27 from Finland and 9 from Denmark). Fifteen patients (42%) had representative growth measurements during the 1st year of life. Genetically verified diagnosis of CHH was made in 15 (42%) patients (KAL1, FGFR1, GNRHR or PROK2).

RESULTS: We found a deceleration of growth rate during early childhood. The mean [SD] length standard deviation score (SDS) at birth (0.2 [1.6] SDS) decreased significantly during the first 3 (to -0.9 [1.2] SDS) and 6 months of life (to -0.7 [1.3] SDS). At the average age of 3 years, mean height SDS (-0.2 [1.3] SDS) did not differ from mid-parental target height (MPH). Mean height SDS reached its nadir (-1.7 [1.4] SDS) at an average age of 15.8 [0.8] years reflecting pubertal failure. Final heights did not differ from MPH. No clear genotype-growth associations emerged.

CONCLUSIONS: Moderate postnatal length deflection is a novel feature of CHH, and may reflect early androgen deficiency. Childhood growth patterns are not of clinical value in targeting molecular genetic diagnosis of CHH.Pediatric Research (2015); doi:10.1038/pr.2015.278.