How can untreated CAH affect growth and puberty?

How can untreated CAH affect growth and puberty?

• A. Delayed puberty in both sexes
• B. No effect on puberty
• C. Excess androgens lead to precocious puberty in girls and advanced bone age with altered growth; may cause growth disturbance
• D. Only affects adults

Answer: (C)

When the adrenals produce excess androgens as a result of CAH, these hormones drive puberty earlier and speed up bone maturation. In girls this can manifest as precocious puberty with signs of androgen exposure, while in both sexes the bones mature faster than the rest of the body (advanced bone age). Because growth is tied to the timing of epiphyseal closure, this early surge of hormones often leads to an initial growth spurt followed by premature closure of the growth plates, which can result in a shorter final adult height. Untreated CAH therefore tends to accelerate puberty and bone maturation and can disturb normal growth patterns. The other options don’t fit because puberty isn’t typically delayed or absent, and the condition clearly affects children, not just adults.

When the adrenals produce excess androgens as a result of CAH, these hormones drive puberty earlier and speed up bone maturation. In girls this can manifest as precocious puberty with signs of androgen exposure, while in both sexes the bones mature faster than the rest of the body (advanced bone age). Because growth is tied to the timing of epiphyseal closure, this early surge of hormones often leads to an initial growth spurt followed by premature closure of the growth plates, which can result in a shorter final adult height. Untreated CAH therefore tends to accelerate puberty and bone maturation and can disturb normal growth patterns. The other options don’t fit because puberty isn’t typically delayed or absent, and the condition clearly affects children, not just adults.