1,3,4,8 Hydrocortisone is preferred over other glucocorticoids because it is short acting and can be given in pulses that mimic natural cortisol secretion. 3,4 Periods of physiologic stress, such as severe illness or surgery, require transient dosages of three to 10 times that used for maintenance therapy. 1,3,4,8 Stress dosages are usually not needed in mild illnesses such as colds or otitis media. 2-4 Corticosteroid replacement therapy must be approached carefully. Consultation with an endocrinologist is recommended for patients who require complex hormone regimens.
Many patients benefit from multidrug therapy.
Nomogram for analysis of 17-hydroxyprogesterone levels during an adrenocorticotropic hormone challenge in patients with suspected congenital adrenal hyperplasia. Note logarithmic scales. Boxes as drawn are arbitrary delineations between various forms of the disease. Hydrocortisone is preferred in the treatment of symptomatic patients with mild congenital adrenal hyperplasia because it is short acting and can be given in pulses that mimic natural cortisol secretion. If one child in a family is already affected by congenital adrenal hyperplasia, the HLA haplotypes of the parents and the affected child should be determined.