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