21-hydroxylase deficiency secondary prevention: Difference between revisions

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{{Congenital adrenal hyperplasia due to 21-hydroxylase deficiency}}
{{21-hydroxylase deficiency}}
{{CMG}} {{AE}} {{AAM}}
{{CMG}}; {{AE}}{{MJ}}
==Overview==
==Overview==
Continued monitoring of hormone balance and careful readjustment of [[glucocorticoid]] dose is helpful in controlling [[fertility]] and preventing [[adrenal crisis]] in patient with congenital adrenal hyperplasia due to 21-hydroxylase deficiency.
Continued monitoring of hormone balance and careful readjustment of [[glucocorticoid]] dose is helpful in controlling [[fertility]] and preventing [[adrenal crisis]] in patient with 21-hydroxylase deficiency.
==Secondary Prevention==
==Secondary Prevention==
===Preventing hyperandrogenism and optimizing fertility===
===Preventing hyperandrogenism and optimizing fertility===
Continued monitoring of hormone balance and careful readjustment of [[glucocorticoid]] dose is helpful in controlling [[fertility]], but as a group, women with congenital adrenal hyperplasia have a lower fertility rate.
Continued monitoring of hormone balance and careful adjustment of [[glucocorticoid]] dose is helpful in controlling [[infertility]]. In general, women with 21-hydroxylase deficiency have a lower fertility rate.<ref name="pmid24083158">{{cite journal |vauthors=Mnif MF, Kamoun M, Kacem FH, Mnif F, Charfi N, Naceur BB, Rekik N, Abid M |title=Reproductive outcomes of female patients with congenital adrenal hyperplasia due to 21-hydroxylase defi ciency |journal=Indian J Endocrinol Metab |volume=17 |issue=5 |pages=790–3 |year=2013 |pmid=24083158 |pmc=3784860 |doi=10.4103/2230-8210.117196 |url=}}</ref>


===Preventing adrenal crisis===
===Preventing adrenal crisis===
*To prevent [[adrenal crisis]], all persons taking glucocorticoids replacement are taught to increase their doses in the event of illness, surgery, severe injury, or severe exhaustion.
To prevent [[adrenal crisis]], all patients taking [[glucocorticoids]] replacement should take bolus dose of [[glucocorticoids]] during severe illness, surgery and severe exhaustion.
*Vomiting warrants an injection (within hours) of hydrocortisone (e.g., SoluCortef) or other glucocorticoid. This recommendation applies to both children and adults.
*Because young children are more susceptible to illnesses and infections than adults, pediatric endocrinologists usually teach parents how to give hydrocortisone injections.


== References ==
== References ==
{{Reflist|2}}
{{Reflist|2}}
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Latest revision as of 15:27, 24 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mehrian Jafarizade, M.D [2]

Overview

Continued monitoring of hormone balance and careful readjustment of glucocorticoid dose is helpful in controlling fertility and preventing adrenal crisis in patient with 21-hydroxylase deficiency.

Secondary Prevention

Preventing hyperandrogenism and optimizing fertility

Continued monitoring of hormone balance and careful adjustment of glucocorticoid dose is helpful in controlling infertility. In general, women with 21-hydroxylase deficiency have a lower fertility rate.[1]

Preventing adrenal crisis

To prevent adrenal crisis, all patients taking glucocorticoids replacement should take bolus dose of glucocorticoids during severe illness, surgery and severe exhaustion.

References

  1. Mnif MF, Kamoun M, Kacem FH, Mnif F, Charfi N, Naceur BB, Rekik N, Abid M (2013). "Reproductive outcomes of female patients with congenital adrenal hyperplasia due to 21-hydroxylase defi ciency". Indian J Endocrinol Metab. 17 (5): 790–3. doi:10.4103/2230-8210.117196. PMC 3784860. PMID 24083158.

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