Audit of management of children and adolescents with congenital adrenal hyperplasia as per recent Endocrine Society guidelines

Lalitha S.; Hemchand Krishna Prasad; Bharath Ramjee; Lakshmi Venugopalan; Nandhini Ganapathy; Balamourougane Paramasamy

doi:10.5114/pedm.2022.122547

eISSN: 2083-8441
ISSN: 2081-237X

Pediatric Endocrinology Diabetes and Metabolism

Current issue Archive Manuscripts accepted About the journal Supplements Editorial board Reviewers Abstracting and indexing Subscription Contact Instructions for authors Publication charge Ethical standards and procedures

Editorial System

Submit your Manuscript

Editorial Policies

Sarajevo Declaration on Integrity and Visibility of Scholarly Publications

Open access

Journal integrated with

1/2023
vol. 29

Send email

Copy url:

abstract:

Original paper

Audit of management of children and adolescents with congenital adrenal hyperplasia as per recent Endocrine Society guidelines

Lalitha Rajalakshmi S.

¹

,

Hemchand Krishna Prasad

²

,

Bharath Ramjee

³

,

Lakshmi Venugopalan

⁴

,

Nandhini Ganapathy

⁵

,

Balamourougane Paramasamy

⁵

Department of Pediatrics, Mehta Multispeciality Hospitals India Pvt Ltd, India
Department of Pediatric Endocrinology, Mehta Multispeciality Hospitals India Pvt Ltd, India
Department of Endocrinology, Mehta Multispeciality Hospitals India Pvt Ltd, India
Department of Neonatology, Mehta Multispeciality Hospitals India Pvt Ltd, India
Department of Pediatric Surgery, Mehta Multispeciality Hospitals India Pvt Ltd, India

Pediatr Endocrinol Diabetes Metab 2023; 29 (1): 10-15

DOI: https://doi.org/10.5114/pedm.2022.122547

Online publish date: 2022/12/21

View full text Get citation

EndNote

Papers, Reference Manager, RefWorks, Zotero

AMA

S. LR, Krishna Prasad H, Ramjee B, Venugopalan L, Ganapathy N, Paramasamy B. Audit of management of children and adolescents with congenital adrenal hyperplasia as per recent Endocrine Society guidelines. Pediatric Endocrinology Diabetes and Metabolism. 2023;29(1):10-15. doi:10.5114/pedm.2022.122547.

APA

S., L. R., Krishna Prasad, H., Ramjee, B., Venugopalan, L., Ganapathy, N.,  & Paramasamy, B. (2023). Audit of management of children and adolescents with congenital adrenal hyperplasia as per recent Endocrine Society guidelines. Pediatric Endocrinology Diabetes and Metabolism, 29(1), 10-15. https://doi.org/10.5114/pedm.2022.122547

Chicago

S., Lalitha R, Hemchand Krishna Prasad, Bharath Ramjee, Lakshmi Venugopalan, Nandhini Ganapathy,  and Balamourougane Paramasamy. 2023. "Audit of management of children and adolescents with congenital adrenal hyperplasia as per recent Endocrine Society guidelines". Pediatric Endocrinology Diabetes and Metabolism 29 (1): 10-15. doi:10.5114/pedm.2022.122547.

Harvard

S., L., Krishna Prasad, H., Ramjee, B., Venugopalan, L., Ganapathy, N.,  and Paramasamy, B. (2023). Audit of management of children and adolescents with congenital adrenal hyperplasia as per recent Endocrine Society guidelines. Pediatric Endocrinology Diabetes and Metabolism, 29(1), pp.10-15. https://doi.org/10.5114/pedm.2022.122547

MLA

S., Lalitha et al. "Audit of management of children and adolescents with congenital adrenal hyperplasia as per recent Endocrine Society guidelines." Pediatric Endocrinology Diabetes and Metabolism, vol. 29, no. 1, 2023, pp. 10-15. doi:10.5114/pedm.2022.122547.

Vancouver

S. L, Krishna Prasad H, Ramjee B, Venugopalan L, Ganapathy N, Paramasamy B. Audit of management of children and adolescents with congenital adrenal hyperplasia as per recent Endocrine Society guidelines. Pediatric Endocrinology Diabetes and Metabolism. 2023;29(1):10-15. doi:10.5114/pedm.2022.122547.

PlumX metrics:

Introduction
In view of the modifications in the endocrine society guidelines on evaluation and management of children with congenital adrenal hyperplasia (CAH), we performed a review of children and adolescents with CAH.

Material and methods
An audit of 35 children with CAH presenting to the pediatric endocrinology clinic between January 2014 to November 2021 was conducted by formulating ten audit questions. The areas of focus included: genital reconstructive surgery, neonatal screening for CAH, stress dosing, need for adrenocorticotrophic hormone (ACTH) stimulation test, growth promoting therapy, bone age assessment, adrenal imaging, bone mineral density assessment, adequacy of hormone replacement and appropriate management of non-classical CAH.

Results
Conservative approach to genitoplasty in female children increased from 42.9% to 88.9%. Newborn screening identified 4 babies including two asymptomatic males averting saltwasting crisis. Stress dosing of steroids were advised in all and emergency usage of injectable glucocorticoids was warranted in two children. Gonadotropin-releasing hormone (GnRH) analogue therapy improved the final median predicted height by 7 cm in 5 children. Twenty-three (65.7%) had bone age assessment with 14 (40%) having advanced bone age. ACTH stimulation test, Adrenal imaging, dual energy X-ray absorptiometry (DEXA) scan were done in accordance with the guideline. One child with nonclassical CAH was initiated on hydrocortisone replacement for advanced bone age.

Conclusions
A shift to conservative surgical management of females, utility of neonatal screening for CAH, judicious use of growth promoting therapy is highlighted. Need for bone age testing, emergency hydrocortisone provision is warranted in our series.

keywords:

Audit of management of children and adolescents with congenital adrenal hyperplasia as per recent Endocrine Society guidelines

Lalitha Rajalakshmi S. 1 , Hemchand Krishna Prasad 2 , Bharath Ramjee 3 , Lakshmi Venugopalan 4 , Nandhini Ganapathy 5 , Balamourougane Paramasamy 5

screening, congenital adrenal hyperplasia, audit, genitoplasty

Lalitha Rajalakshmi S.

¹

,

Hemchand Krishna Prasad

²

,

Bharath Ramjee

³

,

Lakshmi Venugopalan

⁴

,

Nandhini Ganapathy

⁵

,

Balamourougane Paramasamy

⁵