< For Healthcare Providers

Congenital Adrenal Hyperplasia

  • Result: Highly elevated 17-OHP screening values: B.W.≥2500 gms, ≥70 nmol/L; B.W.<2500 gms, ≥140 nmol/L
    • This infant MAY HAVE congenital adrenal hyperplasia (CAH) and immediate follow-up is required. Per Arkansas CAH Newborn Screening protocol, the infant's blood spot will be sent to Arkansas Children's Hospital Laboratory for steroid profile. Results will be available within 2-4 days.

  • Do these tests NOW:
    • "Stat" serum 17-OHP
    • Serial serum electrolytes (look for decreased sodium and increased potassium) and
    • Blood glucose (look for hypoglycemia) – at least until steroid profile results are available

  • Exam the baby TODAY:
    • Affected females usually have ambiguous genitalia, and may even appear to be male with non-palpable testes.
    • Affected males usually have normal genitalia, but may have subtle signs of virilization or increased pigmentation.
    • Both males and females can be at risk for life-threatening adrenal crisis, shock and death.
    • Adrenal crisis symptoms:
      • Emesis
      • Excessive weight loss relative to birth weight
      • Diaphoresis
      • Hyperventilation
      • Pallor, dry mucosa and lethargy.
      • A salt-wasting crisis may develop rapidly.
      • If the newborn shows signs of adrenal crisis, IV glucose/saline and hydrocortisone should be administered upon consultation with a pediatric endocrinologist.
      • If desired, contact Arkansas Children's Hospital Pediatric Endocrinology for assistance with clinical evaluation and interpretation of results: Phone: 501-364-1430.


    • You may wish to refer the patient to Arkansas Children's Hospital for assistance with clinical evaluation and testing.

    Call 501-364-4050 to speak with the Newborn Screening Coordinator to arrange an evaluation or page at 501-364-1100.

    For more information, refer to the health department (ADH) letter that was faxed to you and information at the ADH website.

  • Result: Highly elevated 17-OHP screening values: B.W. ≥2500 gms, ≥70 nmol/L; B.W. <2500 gms, ≥140 nmol/L AND Positive (abnormal) steroid profile: Abnormal result = steroid profile ratio ≥1.5
    • Steroid profile analysis of the original filter paper specimen has been performed, and is positive.
    • This result further raises the risk that this infant has congenital adrenal hyperplasia.

  • Do these tests NOW:
    • "Stat" serum 17-OHP
    • Serial serum electrolytes (look for decreased sodium and increased potassium) and
    • Blood glucose (look for hypoglycemia) – at least until steroid profile results are available

  • Examine the baby TODAY:
    • Affected females usually have ambiguous genitalia, and may even appear to be male with non-palpable testes.
    • Affected males usually have normal genitalia, but may have subtle signs of virilization or increased pigmentation.
    • Both males and females can be at risk for life-threatening adrenal crisis, shock and death.

  • Adrenal crisis symptoms:
    • Emesis
    • Excessive weight loss relative to birth weight
    • Diaphoresis
    • Hyperventilation
    • Pallor, dry mucosa and lethargy
    • A salt-wasting crisis may develop rapidly.
    • If the newborn shows signs of adrenal crisis, IV glucose/saline and hydrocortisone should be administered upon consultation with a pediatric endocrinologist.
    • If desired, contact Arkansas Children’s Hospital Pediatric Endocrinology for assistance with clinical evaluation and interpretation of results at 501-364-1430.

    • You may wish to refer the patient to Arkansas Children’s Hospital for assistance with clinical evaluation and testing.

    For more information, refer to the health department (ADH) letter that was faxed to you and information at the ADH website. Call 501-364-4050 to speak with the Newborn Screening Coordinator to arrange an evaluation or page at 501-364-1100.

  • Result: Highly elevated 17-OHP screening values: B.W. >2500 gms, >55 nmol/L; B.W. <2500 gms, >85 nmol/L
    • This infant MAY HAVE congenital adrenal hyperplasia (CAH) and immediate follow-up is required. Per Arkansas CAH Newborn Screening protocol, the infant's blood spot will be sent to Arkansas Children's Hospital Laboratory for steroid profile. Results will be available within 2-4 days.

  • Do these tests NOW:
    • "Stat" serum 17-OHP
    • Serial serum electrolytes (look for decreased sodium and increased potassium) and
    • Blood glucose (look for hypoglycemia) – at least until steroid profile results are available

  • Examine the baby TODAY:
    • Affected females usually have ambiguous genitalia, and may even appear to be male with non-palpable testes.
    • Affected males usually have normal genitalia, but may have subtle signs of virilization or increased pigmentation.
    • Both males and females can be at risk for life-threatening adrenal crisis, shock and death.
    • Adrenal crisis symptoms:
      • Emesis
      • Excessive weight loss relative to birth weight
      • Diaphoresis
      • Hyperventilation
      • Pallor, dry mucosa and lethargy
      • A salt-wasting crisis may develop rapidly.
      • If the newborn shows signs of adrenal crisis, IV glucose/saline and hydrocortisone should be administered upon consultation with a pediatric endocrinologist.
      • If desired, contact Arkansas Children's Hospital Pediatric Endocrinology for assistance with clinical evaluation and interpretation of results: Phone: 501-364-1430.

    • You may wish to refer the patient to Arkansas Children's Hospital for assistance with clinical evaluation and testing.

    For more information, refer to the health department (ADH) letter that was faxed to you and information at the ADH website. Call 501-364-4050 to speak with the Newborn Screening Coordinator to arrange an Evaluation or page at 501-364-1100.

  • Result: ADH 17-OHP elevated screening values: B.W. >2500 gms, 35-70 nmol/L; B.W. <2500 gms, 55-140 nmol/L
    • Positive (abnormal) steroid profile (ACH positive result = steroid profile ratio >1.5)
    • This infant MAY HAVE congenital adrenal hyperplasia and immediate follow-up is required.

  • Do these tests NOW:
    • "Stat" serum 17-OHP
    • Serial serum electrolytes (look for decreased sodium and increased potassium) and
    • Blood glucose (look for hypoglycemia) – at least until steroid profile results are available

  • Examine the baby TODAY:
    • Affected females usually have ambiguous genitalia, and may even appear to be male with non-palpable testes.
    • Affected males usually have normal genitalia, but may have subtle signs of virilization or increased pigmentation.
    • Both males and females can be at risk for life-threatening adrenal crisis, shock and death.
    • Adrenal crisis symptoms:
      • Emesis
      • Excessive weight loss relative to birth weight
      • Diaphoresis
      • Hyperventilation
      • Pallor, dry mucosa and lethargy
      • A salt-wasting crisis may develop rapidly.
      • If the newborn shows signs of adrenal crisis, IV glucose/saline and hydrocortisone should be administered upon consultation with a pediatric endocrinologist.
      • If desired, contact Arkansas Children's Hospital Pediatric Endocrinology for assistance with clinical evaluation and interpretation of results: Phone: 501-364-1430.

    • You may wish to refer the patient to Arkansas Children's Hospital for assistance with clinical evaluation and testing.

    For more information, refer to the health department (ADH) letter that was faxed to you and information at the ADH website. Call 501-364-4050 to speak with the Newborn Screening Coordinator to arrange an Evaluation or page at 501-364-1100.