The validity of the Bayley-Pinneau method in predicting final adult height at the onset of puberty in patients with classic congenital adrenal hyperplasia

Introduction: The final adult height (FAH) of patients with congenital adrenal hyperplasia (CAH) is often lower than the predicted adult height (PAH) using the Bayley-Pinneau (B&P) method. The aim of the current work was to test the validity of B&P in predicting FAH from a bone age (BA) measurement performed at onset of puberty. Material and ethods: This was a retrospective longitudinal observational convenience single-centre study. The study included 54 patients (male and female) with classic CAH, whether salt-wasting (SW) or simple virilising (SV), who had reached FAH. The results of auxological measurements and hormonal data around the time of puberty were retrieved from files. Predicted adult height (PAH) was calculated from a BA taken at onset of puberty and compared with FAH.  Results: The median PAH SDS at the onset of puberty (–1.5) was significantly greater than the median FAH SDS (–2.2) (p < 0.001). The median target height SDS (–0.8) was significantly higher than the median FAH SDS (–2.2) (p < 0.001). FAH and FAH SDS were significantly worse in females (150.36 ± 7.23; –2.05 ± 1.13) than in their male counterparts (162.86 ± 3.30; –1.53 ± 0.51) (p value < 0.001; 0.048). In patients with good control, there was no difference between PAH SDS (–1.7) and FAH SDS (–1.5) (p value = 0.37). In patients with poor control (over- or under-treated) FAH SDS (–2.1) was significantly lower than PAH SDS (–1.4) (p value < 0.001). Conclusion: The B&P method was able to accurately predict FAH in children with classic CAH, who were medically well controlled (based on 17-hydroxyprogesterone levels), but overestimated it by a significant 0.7 SD in poorly-controlled patients

Growth and Final Height in Children with Autoimmune Hepatitis; A long term observation

Background: Abnormal growth in children with autoimmune hepatitis (AIH) is anticipated, either due to hepatic affection or the growth inhibitory effects of corticosteroids. We aimed to describe children's anthropometry with AIH, and study the factors affecting height.Methods: The present observational study investigates the anthropometric measures of 28 children with AIH followed at a university hospital for 9.5±3 years. We calculated the initial AIH score, the Child-Pugh score, and the pediatric end-stage liver disease score (PELD), follow-up anthropometry, and corticosteroid history. We defined abnormal growth as under nutrition (underweight, wasting, stunting), short stature, overweight, and obesity.Results: At AIH diagnosis, children had a mean age of 7.4±3.1 years, ranging from 2 to 13.8; among whom ~20% had ascites, ~79% had jaundice, and ~82% had type 1 AIH, ~70% had a definite diagnosis of AIH, ~64% were Child-Pugh Score B, ~64% showed severe fibrosis/cirrhosis, and the median PELD score was 8.1 (0.1-12.1). At follow-up, their mean age was 15.9±1.6 years, with mean corticosteroid duration of 7.1±3.1 years, and remission occurred in 50%. We observed a significant improvement in the initial rates of underweight (46.4% vs. 17.8%), mainly stunted, and increased rates of overweight/obesity (14.3% vs. 32.2%). The final rates of height affection without weight affection were comparable to the initials (28.6% vs. 32.1%). Cases with abnormally low final height had significantly more frequent Child-Pugh Score B, higher PELD score, and severe hepatic fibrosis at presentation, with no difference regarding the continuation/ total duration of steroids.Conclusion: the final height in children with AIH is significantly affected by the disease severity at presentation and not the continuation or the duration of corticosteroids use.Background: Abnormal growth in children with autoimmune hepatitis (AIH) is anticipated, either due to hepatic affection or the growth inhibitory effects of corticosteroids. We aimed to describe children's anthropometry with AIH, and study the factors affecting height.Methods: The present observational study investigates the anthropometric measures of 28 children with AIH followed at a university hospital for 9.5±3 years. We calculated the initial AIH score, the Child-Pugh score, and the pediatric end-stage liver disease score (PELD), follow-up anthropometry, and corticosteroid history. We defined abnormal growth as under nutrition (underweight, wasting, stunting), short stature, overweight, and obesity.Results: At AIH diagnosis, children had a mean age of 7.4±3.1 years, ranging from 2 to 13.8; among whom ~20% had ascites, ~79% had jaundice, and ~82% had type 1 AIH, ~70% had a definite diagnosis of AIH, ~64% were Child-Pugh Score B, ~64% showed severe fibrosis/cirrhosis, and the median PELD score was 8.1 (0.1-12.1). At follow-up, their mean age was 15.9±1.6 years, with mean corticosteroid duration of 7.1±3.1 years, and remission occurred in 50%. We observed a significant improvement in the initial rates of underweight (46.4% vs. 17.8%), mainly stunted, and increased rates of overweight/obesity (14.3% vs. 32.2%). The final rates of height affection without weight affection were comparable to the initials (28.6% vs. 32.1%). Cases with abnormally low final height had significantly more frequent Child-Pugh Score B, higher PELD score, and severe hepatic fibrosis at presentation, with no difference regarding the continuation/ total duration of steroids.Conclusion: the final height in children with AIH is significantly affected by the disease severity at presentation and not the continuation or the duration of corticosteroids use

The association between different blood group systems and susceptibility to COVID-19: a single center cross-sectional study from Saudi Arabia

Background: Since the beginning of COVID-19 pandemic, many associated factors have been investigated to clarify the susceptibility and severity among the affected individuals. Biological markers can play an important role in identification of individual susceptibility to such pandemic. Growing evidence suggest the influence of different blood group systems on susceptibility to COVID-19 virus, with a particular blood type conferring selection advantage. Objectives: The study aimed to determine the association of ABO, Rhesus (D) and P1 blood groups with COVID-19 susceptibility in Taif city, Western Saudi Arabia. Methods: ABO, D and P1 blood antigens were determined in 104 blood samples of COVID-19 patients versus 100 control samples using either automated immunohematology analyser or test tube method. Statistical differences between patients and control samples were calculated based on p-value where results of ≤ 0.05 were considered significant. Results: O+ve blood group constituted the predominant type among the studied samples. Determination of P1 antigen showed significant association where Anti-P1 was positive in 76.9% of patients compared to 61.0% of controls with a P value of 0.01 conferring the susceptibility of P1+ve patients to COVID-19. Conclusion: Although our study showed no significant association between ABO and D, and susceptibility to COVID-19, there was a significant association between P1+ve and COVID-19. P1+ve participants were 2.131 times more associated with the risk of COVID-19 infection than those with Anti P1-ve. Thus, P1 antigen can be used as a biological marker for identification of individuals susceptibility to COVID-19. It is strongly advised that such individuals should consider extra protective measures.Further studies on other contributing factors should also be considered for more scientific clarity. Keywords: ABO Blood group; Rh(D); P1 antigen, COVID-19