Congenital Adrenal Hyperplasia (CAH) is a genetic disorder that affects hormone production, leading to dangerous imbalances in cortisol and aldosterone levels. Without proper treatment, babies with severe (salt-wasting) CAH are at risk of life-threatening adrenal crises, which can cause severe dehydration, low blood pressure, and shock.
📌 Fact: Early steroid treatment helps stabilize hormone levels, preventing adrenal crises and allowing normal growth and development.
🩺 Why Is Early Treatment Critical?
Newborns with salt-wasting CAH can rapidly lose sodium and water, leading to:
❌ Severe dehydration – Can occur within the first few weeks of life.
❌ Low blood sugar (hypoglycemia) – Due to cortisol deficiency.
❌ Electrolyte imbalances – Can cause heart problems or seizures.
❌ Adrenal crisis – A life-threatening emergency requiring immediate medical attention.
📌 Fact: Without treatment, adrenal crisis can be fatal within the first few weeks of life.
💊 How Does Steroid Treatment Work?
Lifelong hormone replacement therapy helps restore hormonal balance and prevents life-threatening complications. Treatment includes:
✔ Glucocorticoids (Hydrocortisone, Prednisone, or Dexamethasone) – Replace cortisol to help manage stress and metabolism.
✔ Mineralocorticoids (Fludrocortisone) – Maintain sodium and water balance.
✔ Salt Supplements – Needed for infants with salt-wasting CAH to prevent dehydration.
📌 Fact: With proper steroid therapy, most children with CAH can grow and develop normally.
🚨 Emergency Management of Adrenal Crisis
During illness, injury, or extreme stress, a person with CAH may need:
🔹 Increased steroid doses (“stress dosing”) – To prevent an adrenal crisis.
🔹 Emergency Hydrocortisone Injection – Given if the child is vomiting and cannot take oral steroids.
🔹 Immediate hospital care – If signs of adrenal crisis appear.
📌 Fact: Parents of children with CAH are trained to give emergency steroid injections to prevent adrenal crisis.
📌 Final Thoughts
Early steroid treatment is life-saving for newborns with CAH, preventing adrenal crises, dehydration, and severe complications. With proper medication and monitoring, most children with CAH can lead healthy lives.
