17 alpha-hydroxylase deficiency medical therapy

Revision as of 21:52, 4 February 2016 by Ammu Susheela (talk | contribs)
Jump to navigation Jump to search

Congenital adrenal hyperplasia due to 17 alpha-hydroxylase deficiency Microchapters

Home

Patient Information

Overview

Historical Perspective

Pathophysiology

Causes

Differentiating Congenital adrenal hyperplasia due to 17 alpha-hydroxylase deficiency from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

CT

MRI

Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

17 alpha-hydroxylase deficiency medical therapy On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of 17 alpha-hydroxylase deficiency medical therapy

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on 17 alpha-hydroxylase deficiency medical therapy

CDC on 17 alpha-hydroxylase deficiency medical therapy

17 alpha-hydroxylase deficiency medical therapy in the news

Blogs on 17 alpha-hydroxylase deficiency medical therapy

Directions to Hospitals Treating Congenital adrenal hyperplasia due to 17 alpha-hydroxylase deficiency

Risk calculators and risk factors for 17 alpha-hydroxylase deficiency medical therapy

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

Overview

The mainstay of therapy for congenital adrenal hyperplasia due to 17 alpha-hydroxylase is glucocorticoid therapy.

Medical Therapy

  • Hypertension and mineralocorticoid excess is treated with glucocorticoid replacement, as in other forms of CAH.
  • Hydrocortisone is the drug of choice
  • Most genetic females with both forms of the deficiency will need replacement estrogen to induce puberty. Most will also need periodic progestin to regularize menses. Fertility is usually reduced because egg maturation and ovulation is poorly supported by the reduced intra-ovarian steroid production.
  • The most difficult management decisions are posed by the more ambiguous genetic (XY) males. Most who are severely undervirilized, looking more female than male, are raised as females with surgical removal of the nonfunctional testes. If raised as males, a brief course of testosterone can be given in infancy to induce growth of the penis. Surgery may be able to repair the hypospadias. The testes should be salvaged by orchiopexy if possible. Testosterone must be replaced in order for puberty to occur and continued throughout adult life.

References

Template:WikiDoc Sources