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Adult Consequences of Congenital Adrenal Hyperplasia

Adult Consequences of Congenital Adrenal Hyperplasia Background: Congenital adrenal hyperplasia (CAH) caused by 21-hydroxylase deficiency accounts for 95% of all CAH cases and is one the most common inborn metabolic disorders. While consensus and guidelines on therapeutic management in infancy and childhood are available, data regarding the treatment of adults with CAH are scarce. This review highlights the issues that need to be addressed when caring for the adult CAH patient. Issues include glucocorticoid and mineralocorticoid replacement, adrenal crisis, female and male fertility, genetic counselling, prenatal dexamethasone treatment, pregnancy and the odds of long-term morbidity and mortality in these patients. Conclusions: Large-scale audit studies are urgently required to help optimise management and long-term outcome of these patients, as are optimisation of glucocorticoid replacement and biochemical monitoring tools. It is very important that the adult CAH patient receive regular monitoring by a multidisciplinary team at the secondary- or tertiary-care level. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Hormone Research in Paediatrics Karger

Adult Consequences of Congenital Adrenal Hyperplasia

Hormone Research in Paediatrics , Volume 68 (Suppl 5): 7 – Jan 1, 2007

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References (48)

Publisher
Karger
Copyright
© 2007 S. Karger AG, Basel
ISSN
1663-2818
eISSN
1663-2826
DOI
10.1159/000110615
Publisher site
See Article on Publisher Site

Abstract

Background: Congenital adrenal hyperplasia (CAH) caused by 21-hydroxylase deficiency accounts for 95% of all CAH cases and is one the most common inborn metabolic disorders. While consensus and guidelines on therapeutic management in infancy and childhood are available, data regarding the treatment of adults with CAH are scarce. This review highlights the issues that need to be addressed when caring for the adult CAH patient. Issues include glucocorticoid and mineralocorticoid replacement, adrenal crisis, female and male fertility, genetic counselling, prenatal dexamethasone treatment, pregnancy and the odds of long-term morbidity and mortality in these patients. Conclusions: Large-scale audit studies are urgently required to help optimise management and long-term outcome of these patients, as are optimisation of glucocorticoid replacement and biochemical monitoring tools. It is very important that the adult CAH patient receive regular monitoring by a multidisciplinary team at the secondary- or tertiary-care level.

Journal

Hormone Research in PaediatricsKarger

Published: Jan 1, 2007

Keywords: Glucocorticoid; Adrenal rest; Bone mineral density; Congenital adrenal hyperplasia

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