21-hydroxylase deficiency history and symptoms: Difference between revisions

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* Adult [[short stature]]  
* Adult [[short stature]]  
* Male-typical [[sexual behavior]] in girls and [[cross-gender]] role behavior  
* Male-typical [[sexual behavior]] in girls and [[cross-gender]] role behavior  
* Decreased [[fertility]] due to [[Hyperandrogenism|hyperandrogenemia]] and [[Anovulatory cycle|anovulatory cycles]] ([[fertility]] rate depends the enzyme amount).
* Decreased [[fertility]] due to [[Hyperandrogenism|hyperandrogenemia]] and [[Anovulatory cycle|anovulatory cycles]] ([[fertility]] rate depends the enzyme amount)
|
|
* Normal appearing at birth(mostly)
* Normal appearing at birth(mostly)
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* Deep voice  
* Deep voice  
* Muscle growth
* Muscle growth
* Early [[virilization]] at two to four years of age with ([[pubic hair]], [[Growth spurts|growth spurt]], adult [[body odor]]).
* Early [[virilization]] at two to four years of age with ([[pubic hair]], [[Growth spurts|growth spurt]], adult [[body odor]])
|
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* [[Cognitive function]] disturbance such as IQ impairment
* [[Cognitive function]] disturbance such as IQ impairment
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* No symptoms
* No symptoms
|
|
* Premature pubarche.
* Premature [[pubarche]]
* Advance bone age  
* Advance [[bone age]]
* Medication resistant cystic acne
* Medication resistant [[cystic acne]]
* Accelerated growth with tall stature as a child in prepubertal period
* Accelerated growth with tall stature as a child in pre-[[pubertal]] period
* Hirsutism
* [[Hirsutism]]
* Oligomenorrhea   
* [[Oligomenorrhea]]  
* Acne
* [[Acne]]
* Hirsutism, acne and menstrual irregularity in young women
* [[Hirsutism]], [[acne]] and [[menstrual]] irregularity in young women
* Early pubarche or sexual precocity in school age children
* Early [[pubarche]] or [[sexual]] precocity in school age children
* Mild subfertility due to hyperandrogenemia and anovulatory cycles (fertility rate depends the enzyme amount).
* Mild [[subfertility]] due to [[Hyperandrogenism|hyperandrogenemia]] and [[Anovulatory cycle|anovulatory cycles]] ([[fertility]] rate depends the enzyme amount)
|
|
* No symptoms
* No symptoms


* Premature pubarche.  
* Premature [[pubarche]].  
* Advance bone age  
* Advance [[bone age]]
* Medication resistant cystic acne
* Medication resistant [[cystic acne]]
* Accelerated growth with tall stature as a child
* Accelerated [[growth]] with tall stature as a child
|
|
* Clitoromegaly
* [[Clitoromegaly]]
* Infertility  
* [[Infertility]]
* Alopecia
* [[Alopecia]]
* Primary amenorrhea  
* [[Primary amenorrhea]]
|
|
* Acne
* [[Acne]]
* Infertility
* [[Infertility]]
|} 
|} 


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}

Revision as of 16:59, 1 August 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Mehrian Jafarizade, M.D [2]

Overview

Symptom of 21-hydroxylase deficiency ranges from severe to mild or asymptomatic forms, depending on the degree of 21-hydroxylase enzyme deficiency. There are three main clinical phenotypes: classic salt-wasting, classic non-salt-wasting (simple virilizing), and non-classic (late-onset). In classical type, main symptoms can be sever hypotension due to adrenal crisis, ambiguous genitalia in females, and no symptoms or larger phallus in males. In non-classic types, infants and male patients may have no symptoms and females may show virilization symptoms after puberty.

History and Symptoms

Symptom of 21-hydroxylase deficiency ranges from severe to mild or asymptomatic forms, depending on the degree of 21-hydroxylase enzyme deficiency. There are three main clinical phenotypes: classic salt-wasting, classic non-salt-wasting (simple virilizing), and non-classic (late-onset):[1][2][3][4][5][6][7][8]

21-OH deficiency type Common symptoms Less common symptoms
Infancy Female Male Female Male
Classic type

In salt wasting type

  • Normal appearing at birth(mostly)
  • Male-typical cognitive pattern (better performance on spatial tasks, worse performance on verbal tasks)
Non-classic type
  • No symptoms
  • No symptoms

 

References

  1. Eugster EA, Dimeglio LA, Wright JC, Freidenberg GR, Seshadri R, Pescovitz OH (2001). "Height outcome in congenital adrenal hyperplasia caused by 21-hydroxylase deficiency: a meta-analysis". J Pediatr. 138 (1): 26–32. doi:10.1067/mpd.2001.110527. PMID 11148508.
  2. Mathews GA, Fane BA, Conway GS, Brook CG, Hines M (2009). "Personality and congenital adrenal hyperplasia: possible effects of prenatal androgen exposure". Horm Behav. 55 (2): 285–91. doi:10.1016/j.yhbeh.2008.11.007. PMC 3296092. PMID 19100266.
  3. Mulaikal RM, Migeon CJ, Rock JA (1987). "Fertility rates in female patients with congenital adrenal hyperplasia due to 21-hydroxylase deficiency". N Engl J Med. 316 (4): 178–82. doi:10.1056/NEJM198701223160402. PMID 3491959.
  4. Stikkelbroeck NM, Hermus AR, Braat DD, Otten BJ (2003). "Fertility in women with congenital adrenal hyperplasia due to 21-hydroxylase deficiency". Obstet Gynecol Surv. 58 (4): 275–84. doi:10.1097/01.OGX.0000062966.93819.5B. PMID 12665708.
  5. Hagenfeldt K, Janson PO, Holmdahl G, Falhammar H, Filipsson H, Frisén L; et al. (2008). "Fertility and pregnancy outcome in women with congenital adrenal hyperplasia due to 21-hydroxylase deficiency". Hum Reprod. 23 (7): 1607–13. doi:10.1093/humrep/den118. PMID 18420648.
  6. van der Kamp HJ, Wit JM (2004). "Neonatal screening for congenital adrenal hyperplasia". Eur. J. Endocrinol. 151 Suppl 3: U71–5. PMID 15554889.
  7. White PC, Speiser PW (2000). "Congenital adrenal hyperplasia due to 21-hydroxylase deficiency". Endocr. Rev. 21 (3): 245–91. doi:10.1210/edrv.21.3.0398. PMID 10857554.
  8. Zucker KJ, Bradley SJ, Oliver G, Blake J, Fleming S, Hood J (1996). "Psychosexual development of women with congenital adrenal hyperplasia". Horm Behav. 30 (4): 300–18. doi:10.1006/hbeh.1996.0038. PMID 9047259.