Difference between revisions of "Congenital adrenal hyperplasia"

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{{Sick neonate DDX}}
 
{{Sick neonate DDX}}
  
==Treatment==
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==Management==
 
#[[NS]] 10-20cc/kg bolus
 
#[[NS]] 10-20cc/kg bolus
 
#Steroid replacement
 
#Steroid replacement

Revision as of 02:16, 8 July 2016

Background

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

Diagnosis

  • Patient presents in 2nd week of life in crisis
    • Lethargy, irritability, poor feeding, vomiting, dehydration, shock
  • Salt-wasting
    • Hyponatremia, hyperkalemia
  • Virilization

Work-Up

  • Bedside glucose
  • Chemistry
    • Hyponatremia
    • Hyperkalemia - rarely causes cardiac dysfunction

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.