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Blood Pressure, Fludrocortisone Dose and Plasma Renin Activity in Children with Classic Congenital Adrenal Hyperplasia due to 21-Hydroxylase Deficiency followed from Birth to 4 Years of Age.
MedLine Citation:
PMID:  24818525     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate blood pressure (BP) in infants with CAH due to 21-hydroxylase deficiency.
PATIENTS & METHODS: 33 patients (18f/15m) diagnosed by newborn screening were followed until the age of 4 years. Mean start of HC and FC treatment was day 9.8±9.2 postnatally. Mean daily HC dose ranged from 8.6 to 12.3 mg/m²/day.
RESULTS: During the first year of life prevalence of systolic hypertension was up to 45.5%. At twelve and at 18 months BP was highest. Prevalence of systolic hypertension was up to 57.6% at 18 months of age. After 24 months BP levels were lower and at 48 months prevalence of hypertension decreased to 15.2%. Systolic and diastolic BP correlated significantly with the administered fludrocortisone dose (r=0.3, p=0.005), but not with body mass index. Hypertensive children received significantly higher FC doses and had significantly lower plasma renin activity during the study peroid.
CONCLUSION: High prevalence of transient, most likely FC induced hypertension was found in young children with classic CAH diagnosed by newborn screening. The changing mineralocorticoid sensitivity in infants is a risk factor for the development of hypertension in patients with CAH, who are treated with FC. Therefore suppressed plasma renin activity should be avoided in order to prevent arterial hypertension. This article is protected by copyright. All rights reserved.
Authors:
Walter Bonfig; Hans Peter Schwarz
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-5-13
Journal Detail:
Title:  Clinical endocrinology     Volume:  -     ISSN:  1365-2265     ISO Abbreviation:  Clin. Endocrinol. (Oxf)     Publication Date:  2014 May 
Date Detail:
Created Date:  2014-5-13     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0346653     Medline TA:  Clin Endocrinol (Oxf)     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
This article is protected by copyright. All rights reserved.
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