Difference between revisions of "Congenital adrenal hyperplasia"

(Clinical features/evaluation)
Line 6: Line 6:
 
==Clinical features/evaluation==
 
==Clinical features/evaluation==
 
*Patient presents in 2nd week of life in crisis
 
*Patient presents in 2nd week of life in crisis
**[[Lethargy]], irritability, poor feeding, [[vomiting]], [[dehydration (peds)|dehydration]], [[shock]]
+
**[[Lethargy]], irritability, poor feeding, [[vomiting]], [[dehydration (peds)|dehydration]], [[pediatric shock|shock]]
 
*Salt-wasting
 
*Salt-wasting
 
**[[Hyponatremia]], [[hyperkalemia]]
 
**[[Hyponatremia]], [[hyperkalemia]]

Revision as of 21:59, 25 August 2019

Background

  • 95% of cases due to deficiency of 21-hydroxylase
    • Leads to cortisol deficiency, aldosterone deficiency, virilization
  • Patients present during 2nd-5th week of life in crisis

Clinical features/evaluation

Work-Up

Differential Diagnosis

  • Adrenal salt-wasting crisis

Sick Neonate

THE MISFITS [1]

Management

  1. NS 10-20cc/kg bolus
  2. Steroid replacement
  3. Hyperkalemia

Disposition

Admission

See Also

References

  1. Brousseau T, Sharieff GQ. Newborn emergencies: the first 30 days of life. Pediatr Clin North Am. 2006 Feb;53(1):69-84, vi.