#JustReleased: Congenital Adrenal Hyperplasia Guideline Upda
The Endocrine Society has recently released a guideline update for congenital adrenal hyperplasia (CAH) due to steroid 21-hydroxylase deficiency. The current guidance replaces the one released by the Endocrine Society in 2010.

“The management of congenital adrenal hyperplasia due to 21-hydroxylase deficiency requires a shared decision-making approach that incorporates providers, families and the best interest of the patient, with an effort to consider and incorporate quality-of-life and psychosocial health concerns”, the authors write in the guideline document published in The Journal of Clinical Endocrinology and Metabolism.

Differences between the 2010 and 2018 guidelines:
• Reflects newer published data and prospects of advances in diagnosis and treatments

• Emphasizes shared decision making among congenital adrenal hyperplasia patients, their families, and healthcare professionals when it comes to the medical, surgical, and psychological management of the disorder

• Includes more detailed protocols for adults, especially pregnant women

• Discusses potential new therapies and future ways to improve quality of life for individuals with congenital adrenal hyperplasia

Some of the key recommendations are:-

• All newborn screening programs should incorporate screening for congenital adrenal hyperplasia, and infants with positive screens should be referred to pediatric endocrinologists.

• Prenatal therapy for congenital adrenal hyperplasia should be avoided (except as part of ethically-approved protocols) due to incompletely defined postnatal risks.

• Healthcare professionals should inform all parents of pediatric patients with CAH (particularly girls with ambiguous genitalia) about surgical options, including delaying surgery until the child is older.

• All surgical decisions for minors should be the prerogative of families (i.e., parents with assent from older children) in joint decision making with experienced surgical consultants.

• Adolescents with congenital adrenal hyperplasia should start the transition to adult care several years prior to dismissal from pediatric endocrinology to ensure continuation of care throughout their entire life.

• Growing individuals with classic congenital adrenal hyperplasia should receive maintenance therapy with hydrocortisone and should avoid chronic use of more potent or long-acting glucocorticoids, which can have adverse side effects.

• Patients with congenital adrenal hyperplasia (and parents of minors) should seek mental health treatment to address any congenital adrenal hyperplasia-related psychosocial problems.

About Endocrine Society
The Endocrine Society is a professional, international medical organization in the field of endocrinology and metabolism, founded in 1916. It is a leading organization in the field and publishes four leading journals. It has more than 17,000 members from over 120 countries in medicine, molecular and cellular biology, biochemistry, physiology, genetics, immunology, education, industry, and allied health.

Note: This list is a brief compilation of some of the key recommendations included in the Guidelines and is not exhaustive and does not constitute medical advice. Kindly refer to the original publication here: https://pxmd.co/mu0lB
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