Diagnosis and Treatment of Congenital Virilizing Adrenal Hyperplasia

Abstract

The principle of treatment of congenital virilizing adrenal hyperplasia is to suppress adrenal activity with a cortisonelike steroid, thus preventing formation of precursors which have androgenic and sometimes hypertensive effects. After establishing a depot with initial large doses, the minimal maintenance dose for adequate suppression is determined by the output of urinary 17-ketosteroids. In growing children it is also important to regulate long-range treatment according to rates of growth and osseous development. Cortisone dosage must be greatly increased during periods of stress. In the author's opinion, most of the newer steroids advocated for therapy do not have an advantage over cortisone, desoxycorticosterone acetate or both.