Jornal de pediatria · 2025
Boys with constitutional delay of growth and puberty developed spontaneous puberty and reached standard adult height without pharmacological therapy.
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Luciano Thais Milioni, Stecchini Mônica Freire, Antonini Sonir Roberto Rauber
Аннотация
OBJECTIVES: To evaluate the patterns of pubertal development, growth, and adult height in untreated male patients with CDGP.
METHODS: A retrospective study was conducted at a tertiary care center from 1984 to 2019. Medical records of 46 boys diagnosed with CDGP (after excluding those with hypogonadism) were included for further analysis.
RESULTS: Most patients were born at term (78%) and appropriate for gestational age (85%). A family history of delayed puberty was noted in 50%. The median age at initial evaluation was 14.3 years (range: 4.8-16.2 years). Short stature before puberty was the main reason for seeking medical attention (48%). Short stature was common at the first evaluation (93%) but improved over time; at the final assessment, only 17% of the patients remained short. For those who reached adult height, the height Z-scores were comparable to target height. Predictions using the Bayley-Pinneau method often overestimated adult height. Delayed bone age was present in 82% of patients at initial evaluation. The median age of spontaneous pubertal onset was 15 years, with a median duration of 2.1 years (range: 1.2-4.8 years, n = 33). None of the patients received pharmacological treatment. The median age at Tanner stage G5 was 17.1 years.
CONCLUSIONS: In boys with CDGP, transient short stature improved spontaneously during puberty. Most achieved their target height without growth-promoting therapy. However, adult height predictions based on the Bayley-Pinneau method were often overestimated. Spontaneous puberty initiation and completion occurred at approximately 15 and 17 years of age, respectively.
METHODS: A retrospective study was conducted at a tertiary care center from 1984 to 2019. Medical records of 46 boys diagnosed with CDGP (after excluding those with hypogonadism) were included for further analysis.
RESULTS: Most patients were born at term (78%) and appropriate for gestational age (85%). A family history of delayed puberty was noted in 50%. The median age at initial evaluation was 14.3 years (range: 4.8-16.2 years). Short stature before puberty was the main reason for seeking medical attention (48%). Short stature was common at the first evaluation (93%) but improved over time; at the final assessment, only 17% of the patients remained short. For those who reached adult height, the height Z-scores were comparable to target height. Predictions using the Bayley-Pinneau method often overestimated adult height. Delayed bone age was present in 82% of patients at initial evaluation. The median age of spontaneous pubertal onset was 15 years, with a median duration of 2.1 years (range: 1.2-4.8 years, n = 33). None of the patients received pharmacological treatment. The median age at Tanner stage G5 was 17.1 years.
CONCLUSIONS: In boys with CDGP, transient short stature improved spontaneously during puberty. Most achieved their target height without growth-promoting therapy. However, adult height predictions based on the Bayley-Pinneau method were often overestimated. Spontaneous puberty initiation and completion occurred at approximately 15 and 17 years of age, respectively.