Navigation Links
Experts recommend universal screening of newborns for congenital adrenal hyperplasia

Chevy Chase, MDToday, The Endocrine Society released a new clinical practice guideline on the diagnosis and treatment of congenital adrenal hyperplasia (CAH). The guideline features a series of evidence-based clinical recommendations developed by an expert task force.

The guideline, published in the September 2010 issue of the Journal of Clinical Endocrinology & Metabolism (JCEM), a publication of The Endocrine Society, is endorsed by the American Academy of Pediatrics, Pediatric Endocrine Society, the European Society for Paediatric Endocrinology, the European Society of Endocrinology, the Society for Pediatric Urology, the Androgen Excess and PCOS Society, and the CARES Foundation.

CAH is a genetic disorder of the adrenal glands that affects about one in 10,000 to 20,000 newborns, both male and female. The adrenal glands make the steroid hormones cortisol, aldosterone and androgens. In individuals with CAH, the adrenal glands produce an imbalance of these hormones which can result in ambiguous genitalia in newborn females, infertility and the development of masculine features such as development of pubic hair, rapid growth in both girls and boys before the expected age of puberty.

"If CAH is not recognized and treated, both girls and boys undergo rapid postnatal growth and early sexual development or, in more severe cases, neonatal salt loss and death," said Phyllis Speiser, MD, of Cohen Children's Medical Center of New York and Hofstra University School of Medicine, and chair of the task force that developed the guideline. "We recommend that every newborn be screened for CAH and that positive results be followed up with confirmatory tests."

Other recommendations from the guideline include:

  • Prenatal treatment of CAH should continue to be regarded as experimental. Such therapies should be pursued through protocols approved by Institutional Review Boards at centers capable of collecting outcomes data on a large number of patients so that risks and benefits of this treatment can be defined more precisely;
  • Diagnosis should rest on clinical and hormone data while genotyping should be reserved for equivocal cases and genetic counseling;
  • Regarding treatment, glucocorticoid dosage should be minimized to avoid iatrogenic Cushing's Syndrome. Mineralcorticoids and, in infants, supplemental sodium are recommended in classic CAH patients;
  • Clinicians should avoid the routine use of experimental therapies to promote growth and delay puberty, and patients should avoid adrenalectomy;
  • Early single-stage genital repair should be considered for severely virilized girls and should be performed only by surgeons experienced in this type of procedure;
  • Clinicians should consider patients' quality of life, consulting mental health professionals as appropriate;
  • At the transition to adulthood, clinicians should monitor for potential complications of CAH; and
  • Clinicians should exercise judicious use of medication during pregnancy and in symptomatic patients with nonclassic CAH.

"People with classic CAH should have a team of health care providers, including specialists in pediatric endocrinology, pediatric urologic surgery (for girls), psychology and genetics," said Speiser. "Other than having to take daily medication, people with classic CAH can have a normal life."


Contact: Aaron Lohr
The Endocrine Society

Related medicine news :

1. Local Carrollton Center Hosting More than 50 Autism Experts from Coast-to-Coast
2. Experts call for acceleration of research and interventions for prematurity and stillbirth
3. Verizon Health Care IT Experts to Present at Atlanta Conference on March 2, 3
4. FDA Appoints Highly Qualified Scientific Experts to Tobacco Products Scientific Advisory Committee
5. Experts call for further research into the relationship between insulin therapy and cancer
6. Experts support new federal center for Medicare and Medicaid innovation
7. David Wolfe Hosts 3-Day Longevity Conference: Top Wellness Experts Reveal Tomorrow's Best Natural Health and Nutrition Information Today
8. Alert: Bloomberg to Gather Healthcare Experts in Chicago, April 27th
9. Bipartisan Capitol Hill Media Event: Health Experts, Lawmakers to Urge Federal Government to Fix the Funding Failure for Chronic Viral Hepatitis
10. Two Top Sleep Experts Team Up On New Pillow Collection
11. Experts Say Its Not So Bad to Go a Little Mad
Post Your Comments:
(Date:11/27/2015)... ... November 27, 2015 , ... ... convenient way to dispense prescription medications at home, so he invented the patent-pending ... monitor and dispense prescription medications. In doing so, it could help to prevent ...
(Date:11/27/2015)... ... , ... MPWH, the No.1 Herpes-only dating community in the world, revealed that over 50% of ... than 3.7 billion people under the age of 50 – or 67% of the population ... global estimates of HSV-1 infection . , "The data shocks us highly!" said Michelle ...
(Date:11/27/2015)... ... November 27, 2015 , ... ... online platform for mental health and wellness consultation, has collaborated with a leading ... bridge the knowledge gap experienced by parents and bring advice from parenting experts ...
(Date:11/27/2015)... ... November 27, 2015 , ... Indosoft ... announces the incorporation of Asterisk 11 LTS (Long Term Support) into its Q-Suite ... LTS brings Q-Suite 5.10 up-to-date with a version of Asterisk that will receive ...
(Date:11/26/2015)... ... 2015 , ... The Catalent Applied Drug Delivery Institute today ... dose form selection in early phase drug development. The first of these is ... together the UK’s emerging life sciences companies, corporate partners, and investors, at Milton ...
Breaking Medicine News(10 mins):
(Date:11/26/2015)... 2015 Research and Markets ( ) has ... Market Outlook to 2019 - Rise in Cardiac Disorders and ... report to their offering. Boston ... scientific and others. --> The ... Boston scientific and others. ...
(Date:11/26/2015)... -- Research and Markets ( ) has ... Horizons and Growth Strategies in the Japanese Therapeutic ... Forecasts, Competitive Intelligence, Emerging Opportunities" report to ... --> This new 247-page report provides ... monitoring market, including emerging tests, technologies, instrumentation, sales ...
(Date:11/26/2015)... DUBLIN , November 26, 2015 ... has announced the addition of the  ... in the Global Cell Surface Testing ... Opportunities" report to their offering.  ... the addition of the  "2016 Future ...
Breaking Medicine Technology: