Late (Non-classic) Adrenal Hyperplasia
Fanta M.1, Cibula D.1, Vrbíková J.2, Bendlová B.2, Šnajderová M.3
1Gynekologicko-porodnická klinika VFN a 1. LF UK, Praha, přednosta prof. MUDr. A. Martan, DrSc. 2Endokrinologický ústav, Praha, ředitel doc. MUDr. V. Hainer, CSc. 3Pediatrická klinika FN Motol a 2. LF UK, Praha, přednosta prof. MUDr. J. Vavřinec, DrSc. |
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Summary:
Objective: To summarize available data concerning adrenal hyperandrogenemia caused by 21-hydroxylase
deficiency, non-classic adrenal hyperplasia (NCAH).
Design: Review article.
Setting: Department of Gynecology and Obstetrics, General Faculty Hospital and 1st Medical Faculty,
Prague.
Methods: Compilation of published data from scientific literature.
Conclusion: Although 21-hydroxylase deficiency is one of the most frequent autosomal recessive genetic
disorders, prevalence of NCAH in the whole population and among hyperandrogenic women is very low.
The measurement of 17OH-progesterone should be incorporated into the standard evaluation of all
hyperandrogenic patients to establish or exclude the diagnosis of NCAH. There is no typical clinical sign
of NCAH, and clinical symptoms are to similar to patients with PCOS. Corticoid substitution as a treatment
modality of NCAH is derived from therapy of classic congenital adrenal hyperplasia (CAH). Antiandrogen
therapy is effective in skin disorders (hirsutism). Due to normal cortisol value there is to use of
combined oral contraceptives in the treatment of choice. An improvement of clinical symptoms is a key
parameter for the evaluation of treatment effectiveness. There are no data about risk of late metabolic
complications in NCAH patients.
Key words:
classic adrenal hyperplasia (CAH), non-classic adrenal hyperplasia (NCAH), polycystic ovary
syndrome, 17OH-progesterone, corticoids
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