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Right arrow Endocrinology

AAP Grand Rounds 2:65 (1999)
© 1999 American Academy of Pediatrics

ENDOCRINOLOGY

CAH: Diagnostic Utility of Adrenal Ultrasonography

Source: Al-Alwan I, Navarro O, Daneman D, Daneman A. Clinical utility of adrenal ultrasonography in the diagnosis of congenital adrenal hyperplasia. J Pediatr. 1999;135:71–75.

The first 20% of the full text of this article appears below.

Despite neonatal screening programs for congenital adrenal hyperplasia (CAH) in approximately 20 states, early and precise diagnosis of affected infants remains a challenge. Because 17-hydroxyproges-terone values are quite high shortly after birth in normal infants, the interpretation of test results may be difficult or impossible in the first 3 days of life. Substantial delays (usually about 2 weeks) are inherent in the screening process, and affected patients (particularly affected males) are at some risk for salt-losing adrenal crisis before the neonatal test results are available. Furthermore, in states that screen for CAH physicians must contend with a substantial number of borderline elevated results in normal-appearing females, which often creates parental anxiety and distress until there is a definitive diagnosis. In a retrospective study, Al-Alwain et al examined the utility of adrenal ultrasonography (USG) in the evaluation of infants with and without ambiguous genitalia . . . [Full Text of this Article]

Kenneth Copeland, MD, FAAP
Pediatrics, Baylor College of Medicine, Houston, TX