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Table 1 Typical multidisciplinary protocol for the CAH clinic at The Children's Hospital of Oklahoma.

From: An Evidence-Based Model of Multidisciplinary Care for Patients and Families Affected by Classical Congenital Adrenal Hyperplasia due to 21-Hydroxylase Deficiency

AGE Objectives Visit Schedule Labs Education Urology Psychiatry Support Group
1st Month (i) Metabolic stability
(ii) Provide parents with an understanding of disease and treatment
1, 2 & 4 wks (i) CAH panel every visit
(ii) Electrolytes every visit
(i) Meets with RN each visit re: medical regimen and stress dosing    
Up to 3 years (i) Establish optimal medical regimen
(ii) Feminizing surgery as needed for females
Every 3 mos (i) CAH panel every visit
(ii) Electrolytes through 1st year
(iii) BA yearly starting at age 2
(i) Meets with RN each visit re: medical regimen
(ii) Meets with RN annually re: stress dosing, medic alert, and CAH quiz
Females see urologist at 3, 6, 12 months 3, 12, and 24 mo Every 4 mos
3 y to adolescence (i) Adjust medical regimen to maintain normal growth and health
(ii) Increase child's understanding of condition as appropriate for age
Every 4 mos (i) CAH panel every visit
(ii) BA yearly until epiphyseal fusion
(i) Meets with RN each visit re: medical regimen
(ii) Meets with RN annually re: stress dosing, medic alert, and CAH quiz
Females see urologist prior to menarche Annually or more often as needed Every 4 mos
Adolescence (i) Adjust medical regimen to maintain normal growth, pubertal development and maintain health
(ii) Increase child's understanding of condition as appropriate for age
(iii) Follow-up with Urology for females
Every 4 mos (i) CAH panel every visit
(ii) Annual testicular exam for boys
(i) Meets with RN each visit re: medical regimen
(ii) Meets with RN annually re: stress dosing, medic alert, and CAH quiz
Females see urologist prior to becoming sexually active Annually or more often as needed Every 4 mos
Adulthood (i) Transition to adult medical care Annually CAH panel every visit   As needed Annually or more often as needed Every 4 mos