title: [Aggravation of salt loss due to hydrocortisone in the first days of treatment of congenital adrenal hyperplasia caused by 21-hydroxylase deficiency].
abstract: The longitudinal study of five infants affected with congenital hyperplasia (CAH) due to 21-hydroxylase deficiency illustrate the aggravation of the salt losing syndrome during the initial period of replacement therapy with hydrocortisone alone, associated or not with salt supplementation as demonstrated by weight loss or failure to thrive, hyponatremia and rise in plasma renin activity. Concomitantly, the plasma levels of both ACTH and aldosterone decreased monkedly. The sodium loss was rapidly normalized following the association of small doses (25 gamma/day) of 9 alpha fluorohydrocortisone to the same glucocorticoid replacement dosage. Initial treatment of infants affected with CAH should therefore include both mineral and glucocorticoid hormones.
mesh_terms: D000312:Adrenal Hyperplasia, Congenital / Q000188:drug therapy* / Q000378:metabolism; D002675:Child, Preschool; D004359:Drug Therapy, Combination; D005260:Female; D005438:Fludrocortisone / Q000008:administration & dosage; D006801:Humans; D006854:Hydrocortisone / Q000008:administration & dosage / Q000009:adverse effects*; D007010:Hyponatremia / Q000378:metabolism; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009318:Natriuresis / Q000187:drug effects*
chemical_list: D005438:Fludrocortisone; D006854:Hydrocortisone
vernacular_title: Aggravation de la perte sodée par l'hydrocortisone dans les premiers jours du traitement de l'hyperplasie surrénale congénitale par déficit en 21 - hydroxylase.