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Russian clinical practice guidelines «congenital adrenal hyperplasia»

https://doi.org/10.14341/omet12787

Abstract

Congenital adrenal hyperplasia (CAH) is a group of autosomal recessive diseases characterized by a defect in one of the enzymes or transport proteins involved in the cortisol synthesis in the adrenal cortex. The most common form of CAH, which occurs in more than 90% of cases, is a 21-hydroxylase enzyme deficiency. The latter is subdivided into nonclassical and classic (salt-losing and virilizing) forms. The prevalence of classic forms of 21-hydroxylase deficiency ranges from 1: 14,000 to 1:18,000 live births worldwide. According to the data of neonatal screening in the Russian Federation, the prevalence of the disease in some regions ranges from 1: 5000 to 1: 12000, in the country as a whole - 1: 9638 live newborns. The non-classical form of CAH occurs more often - from 1: 500 to 1: 1000 among the general population. In second place is the hypertensive form of CAH - a deficiency of 11β-hydroxylase, which, according to the literature, occurs in about 1 per 100,000 newborns. These clinical guidelines were compiled by a professional community of narrow specialists, approved by the expert council of the Ministry of Health of the Russian Federation, and updated the previous version published in 2016. The clinical guidelines are based on systematic reviews, meta-analyses and original articles, and scientific work on this issue in the Russian Federation and other countries. The purpose of this document is to provide clinicians with the most up-to-date, evidence-based guidelines for the CAH diagnosis and treatment

About the Authors

N. G. Mokrysheva
Endocrinology Research Centre
Russian Federation

Natalia G. Mokrysheva, MD, PhD

Moscow



G. A. Melnichenko
Endocrinology Research Centre; I.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

Galina A. Melnichenko, MD, PhD, Professor

Moscow



L. V. Adamyan
A.I. Yevdokimov Moscow State University of Medicine and Dentistry
Russian Federation

Leila V. Adamyan, MD, PhD, Professor

Moscow



E. A. Troshina
Endocrinology Research Centre
Russian Federation

Ekaterina A. Troshina, MD, PhD, professor

Moscow



N. V. Molashenko
Endocrinology Research Centre
Russian Federation

Natalya V. Molashenko, MD, PhD

11 Dmitriya Ulyanova street, 117036 Moscow, Russia



A. I. Sazonova
Endocrinology Research Centre
Russian Federation

Anna I. Sazonova, MD, PhD

Moscow



E V. Uvarova
I.M. Sechenov First Moscow State Medical University (Sechenov University); Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology
Russian Federation

Elena V. Uvarova, MD, PhD, Professor

Moscow



R. M. Esayan
Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology
Russian Federation

Roza M. Esayan, MD, PhD, Professor

Moscow



E. N. Andreeva
Endocrinology Research Centre
Russian Federation

Elena N. Andreeva, MD, PhD, Professor

Moscow



Z. A. Uzhegova
Endocrinology Research Centre
Russian Federation

Zhanna A. Uzhegova, MD

Moscow



M. A. Kareva
Endocrinology Research Centre
Russian Federation

Maria A. Kareva, MD, PhD

Moscow



N. Yu. Kalinchenko
Endocrinology Research Centre
Russian Federation

Nataliya Yu. Kalinchenko, MD, PhD

Moscow



B. M. Shifman
Endocrinology Research Centre
Russian Federation

Boris M. Shifman, MD, postgraduate student

Moscow



V. V. Fadeev
I.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

Valentin V. Fadeev, MD, PhD, professor

Moscow



E. V. Biryukova
A.I. Yevdokimov Moscow State University of Medicine and Dentistry
Russian Federation

Elena V. Biryukova, MD, PhD, Professor

Moscow



M. B. Antsiferov
Endocrinology Dispensary of the Moscow Healthcare Department
Russian Federation

Mikhail B. Antsiferov, MD, PhD, Professor

Moscow



L. A. Suplotova
Tyumen State Medical University
Russian Federation

Liudmila A. Suplotova, MD, PhD, Professor

Tyumen



T. P. Kiseleva
Ural State Medical University
Russian Federation

Tatiana P. Kiseleva, MD, PhD, Professor

Ekaterinburg



M. I. Yarmolinskaya
D.O. Ott Scientific and Research Institute of Obstetrics, Gynaecology and Reproductive Medicine named after; I.I. Mechnikov Northwestern State Medical University
Russian Federation

Maria I. Yarmolinskaya

St. Petersburg



L. V. Suturina
Endocrinology Research Centre
Russian Federation

Larisa V. Suturina, MD, PhD, Professor

Moscow



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Supplementary files

1. Figure 1a. Steroidogenesis scheme.
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2. Figure 1b. Pathogenesis of CAH due to deficiency of 21-hydroxylase (P450c21).
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Type Исследовательские инструменты
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3. Figure 1c. Pathogenesis of CAH due to deficiency of 21-hydroxylase (abbreviated).
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4. Figure 2. Pathogenesis of CAH due to 11β-hydroxylase deficiency.
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5. Figure 3. Pathogenesis of metabolic disorders in classic forms of 21-hydroxylase deficiency.
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6. Figure 4. Dynamic observation of adult patients with classic forms of 21-hydroxylase deficiency.
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7. Supplementary Figure B.I. Patient management algorithms (GENERAL DIAGRAM)
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8. Supplementary Figure B.II. Patient management algorithms (ALGORITHM FOR MANAGING ADULT PATIENTS WITH CLASSIC 21-HYDROXYLASE DEFICIENCY FORMS)
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9. Supplementary Figure B.III. Patient management algorithms (ALGORITHM FOR MANAGING ADULT PATIENTS WITH A NONCLASSIC FORM OF 21-HYDROXYLASE DEFICIENCY).
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10. Supplementary Figure G.I. Hirsutism grading according to the modified Ferriman-Gallwey score.
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Review

For citations:


Mokrysheva N.G., Melnichenko G.A., Adamyan L.V., Troshina E.A., Molashenko N.V., Sazonova A.I., Uvarova E.V., Esayan R.M., Andreeva E.N., Uzhegova Z.A., Kareva M.A., Kalinchenko N.Yu., Shifman B.M., Fadeev V.V., Biryukova E.V., Antsiferov M.B., Suplotova L.A., Kiseleva T.P., Yarmolinskaya M.I., Suturina L.V. Russian clinical practice guidelines «congenital adrenal hyperplasia». Obesity and metabolism. 2021;18(3):345-382. (In Russ.) https://doi.org/10.14341/omet12787

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ISSN 2071-8713 (Print)
ISSN 2306-5524 (Online)