title: Nonclassical congenital adrenal hyperplasia: targets of treatment and transition.
abstract: Nonclassical congenital adrenal hyperplasia (NCCAH) caused by 21-hydroxylase deficiency is a common autosomal recessive condition that can present with a wide range of hyperandrogenemic signs in childhood or adulthood. The management of children with NCCAH can be challenging, as no universally accepted guidelines have been established. Our goal was to evaluate the literature and develop an evidence-based guideline for the medical management of children and adolescents with NCCAH. We reviewed the published literature and used the Grading of Recommendation, Assessment, Development, and Evaluation (GRADE) system when appropriate to grade the evidence and provide recommendations for the medical management of children and adolescents with NCCAH, appropriate transition practices from pediatric to adult endocrine care, and psychological issues that should be addressed in parents and patients with NCCAH. We offer recommendations, based on the available evidence, for the management of NCCAH at the different developmental stages from diagnosis through transition to adulthood.
authors.affiliation: Baylor College of Medicine, Texas Children's Hospital, Houston, USA. mccann@bcm.edu
authors.forename: Bonnie
authors.initials: B
authors.lastname: McCann-Crosby
authors.forename: Min-Jye
authors.initials: MJ
authors.lastname: Chen
authors.forename: Sarah K
authors.initials: SK
authors.lastname: Lyons
authors.forename: Yuezhen
authors.initials: Y
authors.lastname: Lin
authors.forename: Marni
authors.initials: M
authors.lastname: Axelrad
authors.forename: Jennifer E
authors.initials: JE
authors.lastname: Dietrich
authors.forename: V Reid
authors.initials: VR
authors.lastname: Sutton
authors.forename: Charles G
authors.initials: CG
authors.lastname: Macias
authors.forename: Sheila
authors.initials: S
authors.lastname: Gunn
authors.forename: Lefkothea
authors.initials: L
authors.lastname: Karaviti
mesh_terms: D000312:Adrenal Hyperplasia, Congenital / Q000175:diagnosis* / Q000628:therapy*; D002648:Child; D004704:Endocrinology / Q000592:standards*; D019317:Evidence-Based Medicine / Q000592:standards; D006801:Humans; D010372:Pediatrics / Q000592:standards*; D017410:Practice Guidelines as Topic