Challenges in Treatment of Patients With Non-Classic Congenital Adrenal Hyperplasia

    December 2022 in “ Frontiers in Endocrinology
    Bas P H Adriaansen, Mariska A M Schröder, P.N. Span, Fred C.G.J. Sweep, Antonius E. van Herwaarden, Hedi L Claahsen–van der Grinten
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    TLDR Treating non-classic congenital adrenal hyperplasia is complex because the benefits of hormone treatment must be weighed against potential health risks.
    The document discusses the challenges in treating patients with non-classic congenital adrenal hyperplasia (NCCAH), a condition that leads to elevated androgen concentrations. Symptoms can vary and include premature pubarche, acne, and irregular menstruation. Glucocorticoid treatment, while it can lower adrenal androgen production, is not generally recommended due to potential negative impacts on the cardiovascular system, metabolic outcome, and bone health. It can also lead to iatrogenic adrenal insufficiency. The document suggests that the decision to start glucocorticoid treatment should be individualized, considering whether the benefits of lowering androgen levels outweigh the negative effects of chronic glucocorticoid treatment. It also highlights the need for more research to establish evidence-based treatment recommendations specifically for NCCAH patients.
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