CAH Clinic (Congenital Adrenal Hyperplasia)

Dedicated specialist clinic for congenital adrenal hyperplasia — diagnosis, lifelong management, and family counselling.

Congenital Adrenal Hyperplasia (CAH) is one of the most important and most misunderstood inherited endocrine conditions. Dr. M.V. Rama Mohan runs a dedicated CAH clinic in Nellore — providing specialist lifelong management for children and adults with CAH, and structured support for their families.

1 in 15,000Classic CAH Births
More CommonNon-Classic (Late-Onset) Form
LifelongSteroid Replacement Needed
CrisisPrevention is Critical
Understanding CAH

What Is Congenital Adrenal Hyperplasia?

CAH is an inherited autosomal recessive enzyme defect — most commonly 21-hydroxylase deficiency — that prevents the adrenal glands from making sufficient cortisol. Without cortisol feedback, the pituitary continuously stimulates the glands, causing adrenal enlargement and androgen overproduction.

Classic CAH (Salt-Wasting & Simple Virilising)
Non-Classic (Late-Onset) CAH
21-Hydroxylase Deficiency
Elevated 17-OHP on Testing
Ambiguous Genitalia at Birth
PCOS-Like Presentation in Females
Classic vs Non-Classic

Two Forms — Both Require Specialist Care

  • Classic CAH: The severe form, presenting at birth. Salt-wasting CAH can cause a life-threatening adrenal crisis in the newborn period. Girls may have virilised genitalia at birth. Requires immediate diagnosis and lifelong steroid replacement.
  • Non-Classic CAH (NCAH): The milder late-onset form, typically presenting in adolescence or adulthood with irregular periods, hirsutism, acne, and fertility difficulties — frequently misdiagnosed as PCOS. Correctly identifying NCAH changes the treatment approach entirely.
What We Offer

Our Dedicated CAH Clinic Services

Accurate Biochemical Diagnosis17-OHP measurement, ACTH stimulation testing, and CYP21A2 genetic analysis coordination where indicated
Steroid Replacement OptimisationPrecision glucocorticoid and mineralocorticoid dosing — suppressing androgens while minimising side effects
Growth & Bone Age MonitoringRegular height velocity tracking and bone age X-rays to detect growth suppression from over-treatment
Puberty ManagementPreventing androgen-driven precocious puberty; managing delayed puberty in undertreated adolescents
Fertility & Pregnancy SupportCoordinated reproductive endocrinology for women with CAH planning pregnancy
Family & Genetic CounsellingGuidance on autosomal recessive inheritance and support for families planning further pregnancies
Adrenal Crisis in CAH — Know the SignsDuring fever, vomiting, injury, or surgery, steroid doses must be increased immediately (sick-day rules). Every CAH patient must carry a Steroid Emergency Card. If vomiting prevents oral medication, injectable hydrocortisone must be given without delay — adrenal crisis can be fatal within hours.
Why a Dedicated CAH Clinic in Nellore?CAH is rare enough that many general endocrinologists see only a handful of cases in their career. Our dedicated clinic means patients in Nellore and surrounding Andhra Pradesh access consistent, protocol-driven specialist care without travelling to Hyderabad or Chennai.