{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T18:11:54Z","timestamp":1788372714545,"version":"build-2803163510"},"reference-count":31,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,10,20]],"date-time":"2020-10-20T00:00:00Z","timestamp":1603152000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100003478","name":"Ministry of Health, Labour and Welfare","doi-asserted-by":"publisher","award":["# 201811056A"],"award-info":[{"award-number":["# 201811056A"]}],"id":[{"id":"10.13039\/501100003478","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>One of the major purposes of newborn screening for 21\u2010hydroxylase deficiency (21OHD) is preventing life\u2010threatening adrenal crisis. However, the details of adrenal crisis in newborns are not precisely documented.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>We aimed to clarify the clinical details of salt\u2010wasting in newborn 21OHD patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Based on the follow\u2010up survey of the screening in Tokyo from 1989 to 2017, we retrospectively analysed the conditions of classical 21OHD neonates before the initiation of therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>One hundred classical 21OHD patients (55 male, 45 female) were analysed. The age at the first hospital visit was 0\u201320\u00a0days with sex difference (male: 9.0\u00a0\u00b1\u00a03.5\u00a0days; female: 6.2\u00a0\u00b1\u00a03.9\u00a0days). Thirty\u2010seven (37.4%) patients exhibited severe salt\u2010wasting (SSW), that is, Na\u00a0&lt;\u00a0130\u00a0mEq\/L, K\u00a0&gt;\u00a07\u00a0mEq\/L or Na\/K ratio\u00a0&lt;\u00a020; except for one case, SSW developed in or after the second week of life. The serum concentrations of Na, K and Na\/K were linearly correlated with age in days (<jats:italic>R<\/jats:italic><jats:sup>2<\/jats:sup>\u00a0=\u00a0.38, .25, and .34 respectively), suggesting that the risk of SSW increases linearly without a threshold. The age at which the regression lines reached Na\u00a0&lt;\u00a0130\u00a0mEq\/L, K\u00a0&gt;\u00a07\u00a0mEq\/L and Na\/K\u00a0&lt;\u00a020 was approximately coincided, 11.1, 12.3 and 11.2\u00a0days, respectively. All SSW patients exhibited decreased body weight from birth in their second week of life.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our data revealed that the risk of developing SSW increases during the second week of life without a threshold, and for preventing SSW, early intervention, ideally during first week of life, is desirable. An increased body weight in the second week of life indicates the absence of SSW.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.14347","type":"journal-article","created":{"date-parts":[[2020,10,1]],"date-time":"2020-10-01T16:34:01Z","timestamp":1601570041000},"page":"229-236","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["The progression of salt\u2010wasting and the body weight change during the first 2\u00a0weeks of life in classical 21\u2010hydroxylase deficiency patients"],"prefix":"10.1111","volume":"94","author":[{"given":"Maki","family":"Gau","sequence":"first","affiliation":[{"name":"Department of Pediatrics and Developmental Biology Tokyo Medical and Dental University (TMDU)  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaoru","family":"Konishi","sequence":"additional","affiliation":[{"name":"Newborn Screening Tokyo Health Service Association  Tokyo 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