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Chapter-064 Management of Adults with Congenital Adrenal Hyperplasia

BOOK TITLE: ESI Manual of Clinical Endocrinology

Author
1. Shah Nalini S
2. Budyal Sweta
ISBN
9789351526476
DOI
10.5005/jp/books/12535_80
Edition
2/e
Publishing Year
2015
Pages
7
Author Affiliations
1. Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India, Seth GS Medical College and KEM, Hospital, Mumbai, Maharashtra, India
2. KEM Hospital, Mumbai, Maharashtra, India
Chapter keywords
Metabolic syndrome, hypertension, osteoporosis, menstrual regularity, circadian rhythm, finasteride, flutamide

Abstract

Congenital adrenal hyperplasia (CAH) is the disorder of steroidogenesis. The health status of CAH patients is harm with increased incidence of infertility, obesity, metabolic syndrome, hypertension, osteoporosis, and poor quality of life (QOL).The main aim of treatment in adult CAH, to control of androgen excess, menstrual regularity, fertility and prevention of metabolic syndrome, and osteoporosis. The newer classifications of adult CAH are more treatment oriented and based on clinical phenotype or genotype. Glucocorticoid (GC) replacement, type and dose of steroids, reverse circadian rhythm, mineralocorticoid replacement and biochemical monitoring are the important factors in the steroids replacement and monitoring. Oral contraceptive pills, antiandrogens like finasteride, flutamide and abiraterone acetate are used for the treatment of androgen excess. CAH effect on the fertility rates and further pregnancy and delivery rates are lower despite treatment for subfertility. TARTs, adrenal tumors, metabolic profile, bone health and quality of life are also discussed in this chapter.

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