The DOI matches its Crossref record; 104 of the 108 references it cites were found in a registry or an index.
Management of adolescents with congenital adrenal hyperplasia
Open accessAbstract
The management of congenital adrenal hyperplasia involves suppression of adrenal androgen production, in addition to treatment of adrenal insufficiency. Management of adolescents with congenital adrenal hyperplasia is especially challenging because changes in the hormonal milieu during puberty can lead to inadequate suppression of adrenal androgens, psychosocial issues often affect adherence to medical therapy, and sexual function plays a major part in adolescence and young adulthood. For these reasons, treatment regimen reassessment is indicated during adolescence. Patients with non-classic congenital adrenal hyperplasia require reassessment regarding the need for glucocorticoid drug treatment. No clinical trials have compared various regimens for classic congenital adrenal hyperplasia in adults, thus therapy is individualised and based on the prevention of adverse outcomes. Extensive patient education is key during transition from paediatric care to adult care and should include education of females with classic congenital adrenal hyperplasia regarding their genital anatomy and surgical history. Common issues for these patients include urinary incontinence, vaginal stenosis, clitoral pain, and cosmetic concerns; for males with classic congenital adrenal hyperplasia, common issues include testicular adrenal rest tumours. Transition from paediatric to adult care is most successful when phased over many years. Education of health-care providers on how to successfully transition patients is greatly needed.
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“Patients with classic 21OH deficiency also have epinephrine deficiency, due to abnormal adrenomedullary formation; 73 this places patients at risk for hypoglycemia, especially when fasting, or during acute illness.”
From Congenital adrenal hyperplasia (2017) · cites this paper as [73]
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Speiser, P. W., Azziz, R., Baskin, L. S., Ghizzoni, L., Hensle, T. W., Merke, D. P., Meyer-Bahlburg, H. F. L., Miller, W. L., Montori, V. M., Oberfield, S. E., et al. (2010) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2009-2631 · Cited by 1,468
Self-citationCongenital Adrenal Hyperplasia
Speiser, P., & White, P. C. (1987) · New England Journal of Medicine · doi:10.1056/nejm198711263172211 · Cited by 1,420
Consensus statement on management of intersex disorders
Hughes, I. A. (2005) · Archives of Disease in Childhood · doi:10.1136/adc.2006.098319 · Cited by 1,414
Congenital adrenal hyperplasia
Speiser, P. W., & White, P. C. (2003) · New England Journal of Medicine · doi:10.1056/nejmra021561 · Cited by 1,405
Menstruation in girls and adolescents: using the menstrual cycle as a vital sign
American Academy of Pediatrics, Committee on Adolescence, American College of Obstetricians and Gynecologists, & Committee on Adolescent Health Care (2006) · PEDIATRICS · doi:10.1542/peds.2006-2481 · Cited by 651
Improving the transition between paediatric and adult healthcare: a systematic review
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High frequency of nonclassical steroid 21-hydroxylase deficiency
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Speiser, P. W., Arlt, W., Auchus, R. J., Baskin, L. S., Conway, G. S., Merke, D. P., Meyer-Bahlburg, H. F. L., Miller, W. L., Murad, M. H., Oberfield, S. E., et al. (2018) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2018-01865 · Cited by 1,234
Self-citationCongenital adrenal hyperplasia
El-Maouche, D., Arlt, W., & Merke, D. P. (2017) · The Lancet · doi:10.1016/s0140-6736(17)31431-9 · Cited by 669
Self-citationGenetics of congenital adrenal hyperplasia
Krone, N., & Arlt, W. (2009) · Best Practice & Research Clinical Endocrinology & Metabolism · doi:10.1016/j.beem.2008.10.014 · Cited by 312
Congenital Adrenal Hyperplasia
Witchel, S. F. (2017) · Journal of Pediatric and Adolescent Gynecology · doi:10.1016/j.jpag.2017.04.001 · Cited by 187
Prenatal androgen exposure causes hypertension and gut microbiota dysbiosis
Sherman, S. B., Sarsour, N. Y., Salehi, M., Schroering, A. G., Mell, B., Joe, B., & Hill, J. W. (2018) · Gut Microbes · doi:10.1080/19490976.2018.1441664 · Cited by 160
Metadata
- Authors
- Merke, D. P., & Poppas, D. P.
- Affiliations
- National Institutes of Health (US)
- NewYork–Presbyterian Hospital (US)
- Corresponding author
- Merke, Deborah P
- ORCID
- Merke, Deborah P
- Venue
- The Lancet Diabetes & Endocrinology
- Publisher
- Elsevier BV
- Published
- 2013-12
- Volume
- 1
- Issue
- 4
- Pages
- 341-352
- ISSN
- 2213-8587 (ISSN-L)
- PMC
- PMC4163910
- OpenAlex
- W2149437278
- Cited by
- 134
- References
- 108
- Citations by year
- 2026: 6 · 2025: 6 · 2024: 12 · 2023: 11 · 2022: 30 · 2021: 13 · 2020: 6 · 2019: 11 · 2018: 12 · 2017: 11 · 2016: 8 · 2015: 6
- FWCI
- 0.44
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- The Lancet Diabetes & Endocrinology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (Z99CL999999)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Sexual Differentiation and Disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
- Keywords
- congenital adrenal hyperplasia, adolescents, puberty, androgen deprivation therapy, glucocorticoid therapy, non-classical congenital adrenal hyperplasia, adrenal insufficiency, medication adherence, sexual function, transition to adult care, patient education, urinary incontinence, vaginal stenosis, clitoral pain, personalized treatment
- MeSH terms
- Adolescent, Adrenal Hyperplasia, Congenital, Glucocorticoids, Humans, Disease Management
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