title: Management of 21-hydroxylase deficiency congenital adrenal hyperplasia: A survey of Canadian paediatric endocrinologists.
abstract: BACKGROUND
  Congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency is one of the most common autosomal recessive disorders. Many issues in the management of CAH in children still remain unresolved.
  
  
  OBJECTIVE
  To assess how children with CAH are treated in Canada.
  
  
  METHODS
  Fifty-nine paediatric endocrinologists and postgraduate trainees from across Canada took part in a survey that evaluated four areas of CAH management: type and dose of glucocorticoid therapy, current use of alternative therapies, monitoring of care, and approach/attitude to prenatal diagnosis and treatment of CAH.
  
  
  CONCLUSIONS
  The present survey demonstrated that there is general agreement among paediatric endocrinologists in Canada regarding the management of patients with CAH, which includes very little use of newer antiandrogen therapies. The goal remains to be the optimization of currently available therapy to ensure normal growth and sexual maturation without any evidence of glucocorticoid excess or deficiency. Prenatal diagnosis and management is widely, but infrequently, used.
authors.affiliation: Division of Endocrinology, Department of Pediatrics, Children's Hospital of Western Ontario and University of Western Ontario, London.
authors.forename: Robert
authors.initials: R
authors.lastname: Stein
authors.forename: Diane
authors.initials: D
authors.lastname: Wherrett
authors.forename: Denis
authors.initials: D
authors.lastname: Daneman
references.citation: J Clin Endocrinol Metab. 2001 Dec;86(12):5651-7
references.pmid: 11739415
references.citation: Arch Dis Child. 1988 Nov;63(11):1399-404
references.pmid: 3060026
references.citation: J Clin Endocrinol Metab. 1994 Feb;78(2):241-6
references.pmid: 8106606
references.citation: J Clin Endocrinol Metab. 1993 Jun;76(6):1505-10
references.pmid: 8501158
references.citation: Pediatrics. 2002 Feb;109(2):E28
references.pmid: 11826238
references.citation: Am J Med. 1995 Jan 16;98(1A):2S-8S
references.pmid: 7825636
references.citation: Horm Res. 1983;18(4):175-85
references.pmid: 6227545
references.citation: Paediatr Drugs. 2001;3(8):599-611
references.pmid: 11577925
references.citation: J Clin Endocrinol Metab. 2000 Mar;85(3):1114-20
references.pmid: 10720048
references.citation: Arch Dis Child. 1989 Sep;64(9):1235-9
references.pmid: 2640553
references.citation: J Pediatr. 2003 Sep;143(3):402-5
references.pmid: 14517528
references.citation: Arch Pediatr. 1994 Apr;1(4):363-7
references.pmid: 7842090
references.citation: Endocr Rev. 2000 Jun;21(3):245-91
references.pmid: 10857554
references.citation: J Clin Endocrinol Metab. 1978 Mar;46(3):452-8
references.pmid: 156192
references.citation: Horm Res. 2002;58(4):188-95
references.pmid: 12324718
references.citation: Klin Padiatr. 1997 Mar-Apr;209(2):71-7
references.pmid: 9113619
references.citation: Arch Dis Child. 1997 Sep;77(3):214-8
references.pmid: 9370898
references.citation: Horm Res. 1980;13(6):347-57
references.pmid: 7196877
references.citation: J Pediatr. 1979 Jul;95(1):33-7
references.pmid: 480011
references.citation: J Paediatr Child Health. 1995 Jun;31(3):222-7
references.pmid: 7669384
references.citation: Pediatrics. 2000 Oct;106(4):767-73
references.pmid: 11015521
references.citation: J Clin Endocrinol Metab. 1996 Sep;81(9):3180-90
references.pmid: 8784066
references.citation: J Pediatr. 1990 Dec;117(6):892-6
references.pmid: 2104527
references.citation: Acta Paediatr Jpn. 1988;30 Suppl:79-88
references.pmid: 3146882
references.citation: J Pediatr. 2002 Aug;141(2):247-52
references.pmid: 12183722
references.citation: J Pediatr Endocrinol. 1993 Apr-Jun;6(2):173-8
references.pmid: 8348221
references.citation: J Pediatr. 1999 Feb;134(2):185-9
references.pmid: 9931527
references.citation: Bull Johns Hopkins Hosp. 1950 Apr;86(4):249-52
references.pmid: 15411555
references.citation: Endocrinol Metab Clin North Am. 2001 Mar;30(1):31-59, vi
references.pmid: 11344938
references.citation: Adv Pediatr. 1995;42:113-43
references.pmid: 8540426