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Has CAH Condition. Treated With Hisone And Floricot. Suggestions?
Question: Hi, Please can you help me with your opinion about the current treatment administered to one of the infants in my family. She is 3 year old and has CAH condition she's been treated with Hisone 5mg and Floricot tabs daily and quarterly tests are scheduled to check her hormone levels. I need to know if this would need to be continued for lifetime or are there any other options available for treatment. Thanks !! PLEASE TREAT THIS AS CONFIDENTIAL INFORMATION.
Brief Answer:
CAH needs long term management.
Detailed Answer:
Dear XXXXXXX
The current treatment instituted for the child is appropriate and it is for LIFETIME with regular monitoring by the appropriate expert. There is no reason to worry taking it for life.
As the case you are talking is a female, she might be having some genital ambiguity as well. Genital corrections are required for that. As the child grows her other hormones also require monitoring. Her growth also needs to be monitored. This is all in the simplest of languages that I could have explained the things to you. You can take the consults from Board Certified Pediatric Endocrinologist in your area.
In summary, CAH or congenital adrenal hyperplasia, is a condition seen since birth where there is enzymatic defect in corticosteroid synthesis, requiring LIFE TIME REPLACEMENT and REGULAR REPLACEMENT of hormones and follow up.
If you have any further or direct query that is hitting you please feel free to ask. Thanks!
CAH needs long term management.
Detailed Answer:
Dear XXXXXXX
The current treatment instituted for the child is appropriate and it is for LIFETIME with regular monitoring by the appropriate expert. There is no reason to worry taking it for life.
As the case you are talking is a female, she might be having some genital ambiguity as well. Genital corrections are required for that. As the child grows her other hormones also require monitoring. Her growth also needs to be monitored. This is all in the simplest of languages that I could have explained the things to you. You can take the consults from Board Certified Pediatric Endocrinologist in your area.
In summary, CAH or congenital adrenal hyperplasia, is a condition seen since birth where there is enzymatic defect in corticosteroid synthesis, requiring LIFE TIME REPLACEMENT and REGULAR REPLACEMENT of hormones and follow up.
If you have any further or direct query that is hitting you please feel free to ask. Thanks!
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks for your prompt reply Dr. XXXXXXX I'm aware of the medical terms used above, her required corrections have been made. My concern is that would taking continuous allopathic medicines have any adverse effects on body organs i.e. kidney, liver etc.. is there homepathic substitutes for this treatment. Would the girl have normal adolescent life: periods, puberty, conception, married life etc that normal females have?
Are there any other concerns that we should anticipate for her future other than replacements/ frequent monitoring. Any warnings that you would want us to be aware of during her growth and phases of schooling/college/higher studies etc..
Many thanks in advance.
Are there any other concerns that we should anticipate for her future other than replacements/ frequent monitoring. Any warnings that you would want us to be aware of during her growth and phases of schooling/college/higher studies etc..
Many thanks in advance.
Brief Answer:
Children with CAH have a normal life.
Detailed Answer:
Dear XXXXXXX Hi. Let me try and answer your queries as you have asked.
1. Allopathic medicines used for the management of CAH i.e. hisone (hydrocortisone) and floricort (fludrocortisone) are the only answers to the condition. No ayurvedic, homeopathic, naturopathic treatment is there that I am aware of.
2. Hydrocortisone and fludrocortisone in the right dose i.e. neither underdosing nor overdosing, do not have significant adverse effects. Specifically liver kidneys heart or any other organ are not damaged by them.
3. The girl will have normal adolescence, with normal onset and progression of puberty. She will also attain normal maturation, undergo normal conception and have normal married life.
4. Warning signs- watch for high fever, infections, vomiting, diarrhea, sick for some other cause. Do not miss the dose, might require doubling the dose if ill for other reasons. Injectable treatment may be required if not able to take orally. Make her carry a badge that she needs to be administered injectable hydrocortisone in case of sudden loss of consciousness, there should be a contact no. in case of any emergency.
4. Future concerns: short height, weight gain, imbalance of electrolytes are certain things to be watched for. At the time of marriage, see that the boy is not a case of CAH, or not even a carrier for the gene of CAH to avoid children suffering from the same condition.
Regards!
Children with CAH have a normal life.
Detailed Answer:
Dear XXXXXXX Hi. Let me try and answer your queries as you have asked.
1. Allopathic medicines used for the management of CAH i.e. hisone (hydrocortisone) and floricort (fludrocortisone) are the only answers to the condition. No ayurvedic, homeopathic, naturopathic treatment is there that I am aware of.
2. Hydrocortisone and fludrocortisone in the right dose i.e. neither underdosing nor overdosing, do not have significant adverse effects. Specifically liver kidneys heart or any other organ are not damaged by them.
3. The girl will have normal adolescence, with normal onset and progression of puberty. She will also attain normal maturation, undergo normal conception and have normal married life.
4. Warning signs- watch for high fever, infections, vomiting, diarrhea, sick for some other cause. Do not miss the dose, might require doubling the dose if ill for other reasons. Injectable treatment may be required if not able to take orally. Make her carry a badge that she needs to be administered injectable hydrocortisone in case of sudden loss of consciousness, there should be a contact no. in case of any emergency.
4. Future concerns: short height, weight gain, imbalance of electrolytes are certain things to be watched for. At the time of marriage, see that the boy is not a case of CAH, or not even a carrier for the gene of CAH to avoid children suffering from the same condition.
Regards!
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Thank you soo much Dr. for reassuring the current treatment with your valuable second opinion. One last set of queries: Current tests done on a quarterly basis to keep check are as follows:
Electrolytes (every quarter)
17 OHP (every quarter)
Plasma renin (not regularly done only when asked)
Hand X-ray to check bone development
Are these sufficient ?
Regards !
Brief Answer:
These are essential and sufficient.
Detailed Answer:
Dear XXXXXXX
Serum Electrolytes, 17 (OH)P, every quarter.
X-Ray Left Hand (AP) view once a year
Height and weight every quarter,
Serum Calcium, serum albumin, CBC once in a quarter or at random
regards and allthe best.
These are essential and sufficient.
Detailed Answer:
Dear XXXXXXX
Serum Electrolytes, 17 (OH)P, every quarter.
X-Ray Left Hand (AP) view once a year
Height and weight every quarter,
Serum Calcium, serum albumin, CBC once in a quarter or at random
regards and allthe best.
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Above answer was peer-reviewed by :
Dr. Shanthi.E
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