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Childhood-diseases

Question
Posted by: Janine | 2019/06/18

Q.

My son where diagnosed with Congenital adrenal hyperplacia.

He is on cortisone 5mg 3 times a day. Covocort, Femara 2.5 and Cipla Cyproterone Acetate 50mg. He is three years and 4 months. I want to know if the medicine is necessary and is there an alternative? He is tall and his bone age is similar to an 8 year old. I do not want to over medicate and I am worried about the long term use of the medication and side effects. Is there alternative treatment available? What else do I need to know about his condition? According to my knowledge his testosterone levels are high but he does not have the salt losing form of CAH. Before the diagnosis a month ago apart from flu and tonsillitis he is a health child. The Doctor said he might not achieve his potential height when fully grown.

Expert's Reply

A.

Paediatrician
- 2019/06/19

This is an important question. This condition is called Congenital Adrenal Hyperplasia. As you can hear by the name of this condition, it is an inherited condition. It seems that your son has the cortisol deficiency form, but he does not lose salt. He also has high testosterone levels. He is likely to grow rapidly in early childhood,but without treatment would end up being shorter than average. With treatment he will grow normally and he will be a normal adult with normal life expectancy. Your son is on the correct treatment. Despite being on the correct treatment, due to the complex nature of CAH in children I would strongly recommend that he is under the care of a paediatric endocrinologist. These experts are quite difficult to find in private practice in South Africa, but your paediatrician should be able to refer you to an expert in your area. If you have any difficulty in locating a paediatric endocrinologist please let me know.

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