Long-term Growth in Congenital Adrenal Hyperplasia

Maheshwari, Ankita; Khadilkar, Vaman; Gangodkar, Priyanka; Khadilkar, Anuradha

doi:10.1007/s12098-018-2753-6

Cited by 6 publications

(4 citation statements)

References 23 publications

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“…It is still possible that a few additional children with mild disease were missed in this cohort. Similar findings are echoed in a retrospective case series from India [31], where precocious puberty and growth failure were reported in most children. CAH is the most common cause of female ambiguity which presents during adolescence [14,16].…”

Section: Disease Burden In India and Need Of Nbssupporting

confidence: 78%

CAH Newborn Screening in India: Challenges and Opportunities

Dabas

Bothra

Kapoor

2020

IJNS

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Congenital adrenal hyperplasia (CAH) is a common treatable disorder which is associated with life-threatening adrenal crisis, sexual ambiguity, and/or abnormal growth if undiagnosed. Newborn screening is a cost-effective tool to detect affected babies early after birth to optimize their treatment and follow-up. Newborn screening however is in its nascent stage in India where it is not yet introduced universally for all babies. The following review briefly highlights the challenges (e.g., lack of universal screening, healthcare resources) and opportunities (e.g., reduction in morbidity and early correct gender assignment in females) associated with newborn screening for CAH in a large Indian birth cohort.

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Section: Disease Burden In India and Need Of Nbssupporting

confidence: 78%

CAH Newborn Screening in India: Challenges and Opportunities

Dabas

Bothra

Kapoor

2020

IJNS

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“…The mean height SDS was described as –0.6. A study from western India described the faltering of height SDS from –0.1 to –0.3 and –0.4 to –0.5 in boys and girls with CAH, respectively [ 18 ]. They described the final height Z-score in a subset at –1.8 in salt wasting CAH and –1.6 in simple virilizing CAH.…”

Section: Discussionmentioning

confidence: 99%

“…It is pivotal that the initiation of GnRH analogue therapy is individualized for every case. Height prediction using Bayley Pinneau tables has recently been reported to be accurate for Indian children with CAH [ 18 ]. These children need to be followed up until they reach their adult height.…”

Section: Discussionmentioning

confidence: 99%

Audit of management of children and adolescents with congenital adrenal hyperplasia as per recent Endocrine Society guidelines

Lalitha¹,

Prasad²,

Ramjee³

et al. 2023

pedm

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Introduction:In view of the modifications in the endocrine society guidelines on evaluation and management of children with congenital adrenal hyperplasia (CAH), we performed a review of children and adolescents with CAH. Material and methods: An audit of 35 children with CAH presenting to the pediatric endocrinology clinic between January 2014 to November 2021 was conducted by formulating ten audit questions. The areas of focus included: genital reconstructive surgery, neonatal screening for CAH, stress dosing, need for adrenocorticotrophic hormone (ACTH) stimulation test, growth promoting therapy, bone age assessment, adrenal imaging, bone mineral density assessment, adequacy of hormone replacement and appropriate management of non-classical CAH. Results: Conservative approach to genitoplasty in female children increased from 42.9% to 88.9%. Newborn screening identified 4 babies including two asymptomatic males averting saltwasting crisis. Stress dosing of steroids were advised in all and emergency usage of injectable glucocorticoids was warranted in two children. Gonadotropin-releasing hormone (GnRH) analogue therapy improved the final median predicted height by 7 cm in 5 children. Twenty-three (65.7%) had bone age assessment with 14 (40%) having advanced bone age. ACTH stimulation test, Adrenal imaging, dual energy X-ray absorptiometry (DEXA) scan were done in accordance with the guideline. One child with nonclassical CAH was initiated on hydrocortisone replacement for advanced bone age. Conclusions: A shift to conservative surgical management of females, utility of neonatal screening for CAH, judicious use of growth promoting therapy is highlighted. Need for bone age testing, emergency hydrocortisone provision is warranted in our series.

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“…This leads to a delay in diagnosis and suboptimal management unless timely referral occurs to a centre where such expertise exists. Another recent Indian study has reported a mean final height SDS of −2.06 ± 1.1 for boys and − 1.47 ± 1.1 for girls with CAH [6].…”

mentioning

confidence: 91%