Document Detail


Management of congenital adrenal hyperplasia in childhood.
MedLine Citation:
PMID:  23037928     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE OF REVIEW: Congenital adrenal hyperplasia (CAH) can present management challenges to the pediatric clinician. Glucocorticoid replacement remains the cornerstone of treatment; however, there are new formulations and delivery mechanisms being studied. Clinicians continue to discuss the optimal treatment of patients from the prenatal stage, through infancy to adulthood. As well, the role of genetics in the clinical care of patients with CAH, and screening for complications, remain topics of discussion. This review will highlight advances made in the past year, as they pertain to the management of pediatric patients with CAH.
RECENT FINDINGS: This article covers recent studies pertaining to optimal medication regimens, including prenatal dexamethasone treatment; medication delivery; monitoring of hormonal control; and the role of genotyping and genetics in the management of children with CAH.
SUMMARY: Much remains to be learned about the optimal management of children with CAH, including fludrocortisone replacement in simple-virilizing patients, frequency of specific monitoring strategies (e.g., electrolytes, bone age), catecholamine status, stress-dosing in nonclassical adrenal hyperplasia, and early screening for complications or metabolic sequelae. Further randomized and prospective studies are needed to address these issues.
Authors:
Mimi S Kim; Anna Ryabets-Lienhard; Mitchell E Geffner
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Current opinion in endocrinology, diabetes, and obesity     Volume:  19     ISSN:  1752-2978     ISO Abbreviation:  Curr Opin Endocrinol Diabetes Obes     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-11-06     Completed Date:  2013-04-30     Revised Date:  2013-07-11    
Medline Journal Info:
Nlm Unique ID:  101308636     Medline TA:  Curr Opin Endocrinol Diabetes Obes     Country:  England    
Other Details:
Languages:  eng     Pagination:  483-8     Citation Subset:  IM    
Affiliation:
Center for Endocrinology, Diabetes, and Metabolism, Children's Hospital Los Angeles, Los Angeles, California 90027, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adrenal Hyperplasia, Congenital / diagnosis,  drug therapy*,  epidemiology
Child
Child, Preschool
Comorbidity
Dexamethasone / administration & dosage*
Drug Administration Schedule
Drug Delivery Systems
Female
Genotype
Glucocorticoids / administration & dosage*
Humans
Infant
Infant, Newborn
Male
Mass Screening
Mothers
Pregnancy
Prenatal Diagnosis / methods*
Grant Support
ID/Acronym/Agency:
KL2 RR031991/RR/NCRR NIH HHS; KL2RR031991/RR/NCRR NIH HHS
Chemical
Reg. No./Substance:
0/Glucocorticoids; 50-02-2/Dexamethasone
Comments/Corrections

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