Management Approaches to Congenital Adrenal Hyperplasia in Adolescents and Adults: Latest Therapeutic Developments

The chapter discussed the management of Congenital Adrenal Hyperplasia (CAH) in adolescents and adults, focusing on glucocorticoid and mineralocorticoid replacement therapy as the gold standard treatment. This approach aimed to address enzyme mutations affecting adrenal steroidogenesis, which led to overactivity of the hypothalamic-pituitary-adrenal axis and renin-angiotensin aldosterone system. The therapy was effective in managing symptoms such as amenorrhea, hirsutism, and alopecia, and in preventing complications like premature epiphyseal closure. However, limitations existed, particularly in non-classical CAH, where balancing androgen production and glucocorticoid dosing was challenging. The chapter also highlighted the importance of adjusting glucocorticoid doses during stress and the potential future directions for CAH treatment, including addressing insulin resistance.