Challenges in Adolescent and Adult Males With Classic Congenital Adrenal Hyperplasia Due to 21-Hydroxylase Deficiency

The Journal of Clinical Endocrinology & Metabolism, Journal Year: 2025, Volume and Issue: 110(Supplement_1), P. S25 - S36

Published: Jan. 21, 2025

Abstract Classic congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency results in severe cortisol and aldosterone deficiency, leading persistent stimulation excess production of ACTH androgens. This review examines the clinical considerations challenges balancing under- overtreatment with glucocorticoids adolescent adult male individuals CAH. Adolescents face many unique that can hinder adherence, hormonal control, transition independence. Thus, patient education is critical during adolescence, especially poorly controlled postpubertal males who lack obvious symptoms may not recognize long-term consequences nonadherence, such as reduced final height, reproductive health, poor bone obesity, hypertension. The risk subfertility/infertility begins early, often have sperm counts, small testes, benign tumors called testicular rest (TARTs). Even good control experience TARTs. In addition, several factors hypogonadism glucocorticoid treatment predispose CAH health (eg, low mineral density, increased osteoporosis/osteopenia fractures) metabolic syndrome insulin resistance, dyslipidemia, hypertension). Regular monitoring recommended, dose optimization prophylactic maximize future fertility potential protect health. Early implementation lifestyle interventions medical are needed address cardiometabolic consequences.

Language: Английский

Management of adult patients with congenital adrenal hyperplasia due to 21-hydroxylase deficiency

Elsevier eBooks, Journal Year: 2024, Volume and Issue: unknown

Published: Jan. 1, 2024

Language: Английский