Adrenal disorders

Abstract

Abnormalities of adrenal function in childhood may be associated with significant disturbance of linear growth. There are several potential mechanisms responsible for this. First, the adrenal disorder may be a component of a dysmorphic syndrome, of which tall or short stature is a feature. This is the case with some ACTH resistance syndromes and the IMAGe association. Secondly, the underlying defect may cause excess secretion of androgens or estrogens, which stimulate linear growth but also advance skeletal maturation leading potentially to adult short stature. This is the case with virilizing congenital adrenal hyperplasia and some adrenal tumors. Thirdly, excess secretion of glucocorticoids, as in Cushing’s syndrome, may retard skeletal maturation and suppress linear growth. The management of each condition needs to be assessed independently in order to normalize growth where possible and achieve optimal adult height.