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 first 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 mo of life (to -0.7 (1.3) SDS). At the average age of 3 y, 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. CONCLUSION: 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.