Breaking News
April 18, 2019 - New gene therapy cures babies with fatal ‘Bubble Boy’ disease
April 18, 2019 - No female mice? Scientists may still approve NIH grant
April 18, 2019 - What needs to be said about mental health in medicine
April 18, 2019 - Hickenlooper Expanded Medicaid, Created State-Run Marketplace To Insure Nearly All Coloradans
April 18, 2019 - Cancer cells grown in tumor-mimicking environment can help predict the effect of experimental drugs
April 18, 2019 - Albireo Announces FDA Clearance of IND to Commence Phase 2 Trial of Elobixibat for the Treatment of NAFLD/NASH
April 18, 2019 - Adhesive gel bonds to eye surface, could repair injuries without surgery
April 18, 2019 - The future of genomics: A podcast featuring Stanford geneticists
April 18, 2019 - As Syphilis Invades Rural America, A Fraying Health Safety Net Is Failing To Stop It
April 18, 2019 - APOE gene impacts sleep depending on gender and severity of Alzheimer’s
April 18, 2019 - PCORI’s newly approved awards focus on cancer pain and opioid use disorders
April 18, 2019 - New tool provides a standard way to measure effects of caring for survivors of TBI
April 18, 2019 - Smartphone use risks eye examination misdiagnosis
April 18, 2019 - How drug-resistant bugs grow in CF patients’ lungs
April 18, 2019 - Gordana Vunjak-Novakovic Elected to American Academy of Arts & Sciences
April 18, 2019 - Podcast: KHN’s ‘What The Health?’ You Have Questions, We Have Answers
April 18, 2019 - Diabetic drug shows potential to be repurposed as heart disease treatment for non-diabetic patients
April 18, 2019 - New estimation method assesses natural variations in sex ratio at birth
April 18, 2019 - UTA scientist receives $1.17 million grant for cancer research
April 18, 2019 - Coagulation factor VIIa prevents bleeds in hemophilia animal models
April 18, 2019 - Researchers identify risk factors for severe infection after knee replacement
April 18, 2019 - Mass drug administration can offer community-level protection against malaria
April 18, 2019 - FDA’s added sugar label could have substantial health and cost-saving benefits
April 18, 2019 - Researchers identify cause of inherited metabolic disorder
April 18, 2019 - Single strip of white paint not sufficient to protect people who ride bikes
April 18, 2019 - Partner status influences link between sexual problems and self-efficacy in breast cancer survivors
April 18, 2019 - Colorectal Neoplasia Risk Up for Hodgkin Lymphoma Survivors
April 18, 2019 - Rigid spine muscular dystrophy – Genetics Home Reference
April 18, 2019 - Simple bile acid blood test could tell risk of stillbirth
April 18, 2019 - Center for Experimental Therapeutics aims to enable all steps of drug development | News Center
April 18, 2019 - Falling for telephone scams could be an early sign of dementia
April 18, 2019 - Researchers annotate key neuronal proteins in lamprey genome
April 18, 2019 - Study uncovers new biomarker for personalized cancer treatments
April 18, 2019 - Scientists enter research collaboration to find a cure for cancer
April 18, 2019 - Study to compare benefits of tai chi and mindfulness meditation on MS symptoms
April 18, 2019 - Gestational diabetes during pregnancy may increase risk of type 1 diabetes in children
April 18, 2019 - Is a New Remedy for Body Odor on the Horizon?
April 18, 2019 - Orthostatic hypotension – Genetics Home Reference
April 18, 2019 - Healing the heartbreak of stillbirth and newborn death
April 18, 2019 - Conference to highlight advances in human immune monitoring, bioinformatics | News Center
April 18, 2019 - Bacteria use viruses for self-recognition, study reveals
April 18, 2019 - New adhesive patch could help reduce post-heart attack muscle damage
April 18, 2019 - Researchers analyze the effects of dark play in a serious video game
April 18, 2019 - Scientists revive pig brain cells four hours after death
April 18, 2019 - Filial cannibalism and offspring abandonment may be forms of parental care
April 18, 2019 - Two proteins act in concert to maintain a healthy heart in mice, shows study
April 18, 2019 - Scientists create a functioning 3D printed heart
April 18, 2019 - Non-invasive vagus nerve stimulation improves disease symptoms in patients with rheumatoid arthritis
April 18, 2019 - Majority of men struggle to understand diagnosis and treatment of prostate cancer
April 18, 2019 - Researchers create new small molecules that may combat equine encephalitis viruses
April 18, 2019 - Animal-assisted therapy improves social behavior in patients with brain injuries
April 18, 2019 - Some viruses help protect harmful bacteria in CF patients | News Center
April 18, 2019 - Outpatient healthcare providers inappropriately prescribe antibiotics to 40% of patients
April 18, 2019 - Men who have a resting heart rate of 75 bpm are twice as likely to die early
April 18, 2019 - Novel serum biomarkers to detect NAFLD-related fibrosis
April 18, 2019 - New study delves deeper into individual genomic differences than ever before
April 18, 2019 - Gilead and Galapagos Announce Filgotinib Meets Primary Endpoint in the Phase 3 FINCH 3 Study in Methotrexate-Naïve Rheumatoid Arthritis Patients
April 18, 2019 - Emotional mirror neurons found in rats
April 18, 2019 - Sylvia Plevritis appointed chair of biomedical data science | News Center
April 18, 2019 - Cervical cancer subtype increasing in several subpopulations of women
April 18, 2019 - Yeast strain provides manufacturing boost to low-calorie sweetener derived from lactose
April 18, 2019 - One in five children and youth suffer from a mental disorder
April 18, 2019 - Improper inhaler use common in children with asthma
April 18, 2019 - C-Path and CDISC release global Therapeutic Area Standard for HIV research
April 18, 2019 - Integrating AI to analyze imaging data allows early recognition of heart disease
April 18, 2019 - Low-cost, high-speed algorithm may allow animal-free chemical toxicity testing
April 18, 2019 - HPV-negative cervical cancers are more aggressive with worse prognosis
April 18, 2019 - AI detects prostate cancer with same level of accuracy as experienced radiologists
April 18, 2019 - Study resolves sex differences in psychiatric illness risk
April 18, 2019 - Novartis Announces FDA Filing Acceptance and Priority Review of Brolucizumab (RTH258) for Patients with Wet AMD
April 18, 2019 - Cocktail of common antibiotics can fight resistant E. coli
April 18, 2019 - Persis Drell to give keynote address at medical school diploma ceremony | News Center
April 18, 2019 - EpicTogether: Remembering Our Why
April 18, 2019 - Study identifies novel loci contributing to asthma susceptibility in adults
April 18, 2019 - Gut bacteria and pregnancy
April 18, 2019 - New study finds that screening could help prevent rare types of cervical cancer
April 17, 2019 - Spatial orgnization of the genome can be altered using small molecules
April 17, 2019 - AEDs Tied to Higher Pneumonia Risk in Alzheimer Patients
April 17, 2019 - Telemedicine tied to more antibiotics for kids, study finds
April 17, 2019 - Two medical students awarded 2019 Soros Fellowships for New Americans | News Center
Shared decision making needed to diagnose, treat, and manage patients with CAH

Shared decision making needed to diagnose, treat, and manage patients with CAH

image_pdfDownload PDFimage_print

The Endocrine Society today issued a Clinical Practice Guideline that offers best practices for healthcare providers on how to promptly diagnose, treat, and manage patients with congenital adrenal hyperplasia (CAH), an inherited endocrine disorder, throughout their entire lives.

The guideline, titled “Congenital Adrenal Hyperplasia Due to Steroid 21-Hydroxylase Deficiency: An Endocrine Society Clinical Practice Guideline,” was published online and will appear in the October 2018 print issue of The Journal of Clinical Endocrinology & Metabolism (JCEM), a publication of the Endocrine Society. This is an update of the Society’s 2010 Guideline, to reflect newer published data and prospects of advances in diagnosis and treatments. The guideline emphasizes shared decision making among CAH patients, their families, and healthcare professionals when it comes to the medical, surgical, and psychological management of the disorder.

Congenital adrenal hyperplasia (CAH) is an inherited genetic disorder in which the adrenal glands, which make essential hormones for body functions, do not function properly. Classic CAH, which is common enough that it is screened shortly after birth in many countries, may cause life-threatening episodes of shock due to salt-wasting and dehydration. Female infants are usually diagnosed at birth because they have ambiguous genitalia (external sex organs that resemble male genitals). However, they still have normal internal female organs (ovaries and uterus). A male infant with classic CAH usually appears normal at birth, although he may show signs of early puberty.

Non-classic CAH is a milder and more common form of the disorder that may not appear until childhood or adulthood. Symptoms can include early pubic hair growth and acne, masculine characteristics, and infertility. With proper care, people with either type of CAH can live long and healthy lives.

“The management of CAH requires a multi-disciplinary team of experienced healthcare personnel who integrate the endocrine, genetic, gyneco-urologic, reproductive, and mental health aspects of care,” said Phyllis W. Speiser, M.D., of the Cohen Children’s Medical Center of New York, Northwell Health, and the Zucker Hofstra School of Medicine in New York. Speiser chaired the writing committee that developed the guideline. “Our new guideline stresses the importance of shared decision making between healthcare professionals, patients, and their families when it comes to treatment and the need for ongoing care.”

Recommendations from the guideline include:

  • All newborn screening programs should incorporate screening for CAH, and infants with positive screens should be referred to pediatric endocrinologists.
  • Prenatal therapy for CAH should be avoided (except as part of ethically-approved protocols) due to incompletely defined postnatal risks.
  • Healthcare professionals should inform all parents of pediatric patients with CAH (particularly girls with ambiguous genitalia) about surgical options, including delaying surgery until the child is older.
  • All surgical decisions for minors should be the prerogative of families (i.e., parents with assent from older children) in joint decision making with experienced surgical consultants.
  • Adolescents with CAH should start the transition to adult care several years prior to dismissal from pediatric endocrinology to ensure continuation of care throughout their entire life.
  • Growing individuals with classic CAH should receive maintenance therapy with hydrocortisone and should avoid chronic use of more potent or long-acting glucocorticoids, which can have adverse side effects.
  • Patients with CAH (and parents of minors) should seek mental health treatment to address any CAH-related psychosocial problems.

Source:

https://www.endocrine.org/news-room/2018/managing-congenital-adrenal-hyperplasia-requires-shared-decisions

Tagged with:

About author

Related Articles