Difference between revisions of "Congenital adrenal hyperplasia"

 
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==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]]
 
*Virilization
 
*Virilization
 +
*Partial CAH may present later and less dramatically with irregular menses in adolescence
  
 
==Work-Up==
 
==Work-Up==
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==Disposition==
 
==Disposition==
Admission
+
*Admit
  
 
==See Also==
 
==See Also==

Latest revision as of 21:16, 5 October 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

  • Admit

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.