Neonate with vomiting

A 10 days old boy presented with decreased urine output for 1 day and 8 episodes of vomiting and stomach ache for 2-3 days. Child looks pale and fabrile. He is not eating properly. No history of fever or diarrhea. No family history of any such disease. He is the second child to the mother. his other subling has no such complaint. Both pregnancies were uncomplicated, Child was born with a birth weight of 3.4 kg. He is on breastfeeding. Temp. and BP was normal, Pulse 150 bpm. Buccal mucosa was dry, and skin was slightly dull. Serum Electrolytes Na: 131 mEq/l K: 6.7 mEq/l Cl: 103 mEq/l S. Creatinine & Blood urea: WNL Serum 17-hydroxyprogesterone: 15 mg/ml (high) How this case should be managed?



It is a case of congenital adrenal hyperplasia. Treatment 1 To correct dehydration and electrolyte imbalance.2 corticosteroids to replace cortisol.3minerelicorticoids to replacealdosteron tohelp to retain salt andto get rid of excess potassium.4to exa. Growth and development .to monitor side effect of replaced steroid. To check hormones level. Reconstructive surgery if needed for normal genital function.

Case of congenital adrenal hyperplasia. Examine the genitalia of child too. Random blood sugar. Correct hyperkalemia first. With inj soda bicarb n inj calcium gluconate . Monitor ecg changes. If it persists go for iv furosemide. Maintain hydration. Cbc crp blood c/s . Need replacement with both glucocorticoids n mineralocorticoids.

Hi Sir !! I think in boy their is normal genitalia

CAH !! Life long therapy !!