Question of the Week

Question :
Posted On : 21 Dec 2017
new born full term i.u.g.r. female { confirmed by presence of uterus and well formed overies} with enlarged clitoris, with 17 oh progedterone 5.7ng, ml { metro polis lab reference Less than 0.07 to 2.7 ng, ml} , sr. electrolytes are within normal level. baby is not having any complain exept enlarged clitoris. QUERIES - is it a case of congenital adrenal hyperplasia _? what is the sagnificant values for 17 oh progedterone _? in this case when to repeate invedtigation _? what is the recommanded dose of hydrocortisone, in C.A.H. management _? how to moniter C.A.H. management _? can we use tb. Prednisolone in replacement to hydrocort. in such case_? with what dose_?
Expert Answer :
THis patient needs to be managed by a pediatric endocrinologist.
Diagnosis is by estimation of serum 17 hydroxy progesterone which is elevated {usually More than 20 ng, ml}. Hydrocortisone is recommended in the dose of 10-20 mg, m 2, day in 2-3 divided doses. Salt wasters also require mineralocorticoid therapy. 9 Flurohydrocortisone is supplemented in the dose of 0.05-0.3 mg daily as single or 2 divided doses. Patients with 21-hydroxylase deficiency require monitoring in form of anthropometry, blood pressure, bone age, status of secondary sexual characters, S.electrolytes and S. 17 OH progesterone levels once in 3-6 months.
Answer Discussion :
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Yea its CAH
3 years ago

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