Which is appropriate for treatment of congenital adrenal hyperplasia in a child?

The choice of prednisone for the treatment of congenital adrenal hyperplasia (CAH) in a child is appropriate due to the underlying pathology of this condition. CAH is predominantly caused by a deficiency in enzymes involved in adrenal steroid hormone synthesis, most commonly 21-hydroxylase. This deficiency leads to an inadequate production of cortisol and an excess of adrenal androgens, which can cause various symptoms such as ambiguous genitalia in newborn girls, precocious puberty, and other hormonal imbalances.

Prednisone is a corticosteroid that serves to substitute for the deficient cortisol. Its administration helps to restore normal cortisol levels, which can reduce the stimulation of the adrenal glands by ACTH (adrenocorticotropic hormone). By compensating for the lack of cortisol, prednisone can also alleviate the symptoms associated with the excess androgen production.

Additionally, the dosing of prednisone can be carefully adjusted to manage the conditions effectively without causing significant side effects. This corticosteroid treatment is aimed at managing the physiological hormonal levels in children with CAH, thereby improving their quality of life and preventing the complications arising from the disorder.

In contrast, the other options do not address the core issue of CAH directly. Adrenocorticotropic hormone (ACTH) would not be helpful