Abstract
Marginal salt loss and hyperreninemia were previously reported in patients with 11-OHD on glucocorticoid replacement (JCEM 58:384, 1984). To evaluate the need for mineralocorticoid therapy, 7 patients with 11-OHD, 5-14 years of age, were subjected to 3 consecutive schedules of treatment: 1) 1 mg/day dexamethasone (DEX) for 4 days, 2) 17 mg/m2<day hydrocortisone acetate (HC) for 4 days, and 3) HC and 0.1-0.2 mg/day 9α-fluorohydrocortisone (9αF) for 10 days. Results (mean±SD) were compared to multiple determinations before the protocol (PRE):
The latter combination suppressed PRA, produced better control of the pituitary-adrenal axis and enabled the use of a physiologic dose of HC. PRA needs to be monitored in 11-OHD patients; when it is elevated, mineralocorticoid replacement is indicated.
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Hochberg, Z., Benderly, A., Kahana, L. et al. MINERAL OCORTICOID REPLACEMENT IN 11β-HYDROXYLASE DEFICIENCY (11-OHD). Pediatr Res 20, 1201 (1986). https://doi.org/10.1203/00006450-198611000-00166
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DOI: https://doi.org/10.1203/00006450-198611000-00166
