Congenital adrenal hyperplasia owing to 21-hydroxylase deficiency - Growth, development, and therapeutic considerations

The goal of congenital adrenal hyperplasia (CAH) treatment is to replace hormones that are missing (cortisol and aldosterone) and suppress excess androgen production This can be accomplished by administering cortisol in an amount equal to physiologic production. Unfortunately, normal cortisol secretion is difficult to mimic. Treatment must therefore be adjusted carefully, as both over- and under-treatment can result in adult short stature. Outcome studies indicate that final adult height in men and women with CAH falls below the predicted genetic potential. A discussion of potential therapeutic improvements is presented.