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18-Hydroxylase Deficiency

FHHA1A


Presentation

  • HISTORY Similarly, most patients with a gastro-enterological and neurological problem will present with a specific Present history symptom - diarrhoea, or tremor - which will direct attention to that organ system.[books.google.de]
  • A 15-year-old phenotypic female with XY genotype presented with male pseudohermaphroditism, gynecomastia, hypokalemic alkalosis, and hypertension. Being raised as a girl, the patient failed to menstruate and developed no sexual hair.[ncbi.nlm.nih.gov]
  • A study of the regulation of normal steroidogenesis by adrenocortical structure is well presented. A chapter is devoted to possible role of vascular system in neural stimulations.[books.google.com]
  • Case presentation We describe a 33-year old Chinese man who presented in infancy with life-threatening hyponatraemia and failure to thrive, but remained asymptomatic on fludrocortisone since.[bmcendocrdisord.biomedcentral.com]
  • They may present with hypertension. Clinical presentation in males 21-hydroxylase deficiency in males is generally not identified in the neonatal period because the genitalia are normal.[emedicine.medscape.com]
Poor Feeding
  • Infants with StAR deficiency (lipoid adrenal hyperplasia) usually have signs of adrenal insufficiency (eg, poor feeding, vomiting, dehydration, hypotension, hyponatremia, hyperkalemia).[emedicine.medscape.com]
  • He had repeated vomiting with poor feeding and failure to thrive at 5 weeks of age.[bmcendocrdisord.biomedcentral.com]
Dysphagia
  • Unlike most other body Hypothalamus Headaches Pituitary Headaches, visual defect 'systems' the very nature of the endocrine system Thyroid Pressure symptoms, dysphagia, ensures that the effects of disordered function in a goitre gland affect the body[books.google.de]
Hypotension
  • Classification endocrine, genetic Phenotypes Autosomal recessive inheritance ; Decreased circulating aldosterone level ; Dehydration ; Episodic fever ; Failure to thrive ; Feeding difficulties in infancy ; Growth delay ; Hyperkalemia ; Hyponatremia ; Hypotension[mousephenotype.org]
  • -Hypotension -Loss of Sodium Increased Plasma Potassium -Fall in glucose due to glucocorticoid deficiency -High ACTH (From POMC), resulting in increased pigmentation -Eventual death due to severe hypotension What are the tests used to confirm Addison's[quizlet.com]
  • However, termination of mineralocorticoid may lead to postural hypotension and hyperkalaemia when triggered by stress due to dehydration or reduced salt intake in some affected adults [ 12 ].[bmcendocrdisord.biomedcentral.com]
  • Hypoglycemia and hypotension may, in part, be due to associated epinephrine synthesis in the adrenal medulla due to cortisol deficiency.[emedicine.medscape.com]
  • Hypotension MedGen UID: 5715 • Concept ID: C0020649 • Finding Abnormally low BLOOD PRESSURE that can result in inadequate blood flow to the brain and other vital organs.[ncbi.nlm.nih.gov]
Palpitations
  • Most patients with a cardiac problem present with one or more specific symptoms such as chest pain, palpitations and oedema.[books.google.de]
  • An increase in the production of catecholamines causes symptoms (mainly headaches, palpitations and excess sweating) and signs (mainly hypertension, weight loss and diabetes) reflecting the effects of epinephrine and norepinephrine on alpha- and beta-adrenergic[medicbind.com]
Chest Pain
  • Most patients with a cardiac problem present with one or more specific symptoms such as chest pain, palpitations and oedema.[books.google.de]
Hearing Impairment
  • Impairment 188 Future Developments 232 Congenital Adrenal Hyperplasia 251 Enzymatic Defects in Congenital Adrenal Hyperplasia and Lab 258 Nonvirilizing Syndromes of Congenital Adrenal Hyperplasia 29 l 291 Differential Diagnosis of Congenital Adrenal[books.google.com]
Withdrawn
  • […] symbols: ALDOS, CPN2, CYP11B, CYP11BL, P-450C18, P450aldo ) Mouse Orthologs Cyp11b1 (Withdrawn symbols: AA389061, Cyp11b, Cyp11b-1 ) Source OMIM:203400 (names, synonyms, disease associated genes) , Orphanet (disease classes) , HGNC, Ensembl, MGI (gene[mousephenotype.org]
  • Hydrocortisone can be withdrawn once characteristic steroid profile or genetic mutations of CYP11B2 gene are confirmed.[bmcendocrdisord.biomedcentral.com]
Tremor
  • HISTORY Similarly, most patients with a gastro-enterological and neurological problem will present with a specific Present history symptom - diarrhoea, or tremor - which will direct attention to that organ system.[books.google.de]
  • In some cases, people with TH-deficient DRD have additional movement problems such as shaking when holding a position (postural tremor) or involuntary upward-rolling movements of the eyes.[ghr.nlm.nih.gov]
Neonate-Onset
  • onset ; Renal salt wasting ; Vomiting Associated Genes CYP11B2 (Withdrawn symbols: ALDOS, CPN2, CYP11B, CYP11BL, P-450C18, P450aldo ) Mouse Orthologs Cyp11b1 (Withdrawn symbols: AA389061, Cyp11b, Cyp11b-1 ) Source OMIM:203400 (names, synonyms, disease[mousephenotype.org]
  • Congenital adrenal hyperplasia: an endocrine disorder with neonatal onset. Crit Care Nurs Clin North Am. 2009;21:195–212. 2. New M, Ghizzoni L, Lin-Su K. An update of congenital adrenal hyperplasia. En: Lifshitz F, editor. Pediatric endocronology.[revistas.fucsalud.edu.co]

Treatment

  • Make the best clinical decisions with an enhanced emphasis on evidence-based practice and expert opinions on treatment strategies. Zero in on the most relevant and useful references with the aid of a more focused, concise bibliography.[books.google.de]
  • Rapidly consult with trusted authorities thanks to new expert-opinion treatment strategies and recommendations. Zero in on the most relevant and useful references with the aid of a more focused, concise bibliography.[books.google.de]
  • […] chromatography patients Pediatrics phenylalanine phenylketonuria plasma population prenatal recessive reported result screening programs Scriver sensorineural sickle cell significant specific studies syndrome Table techniques testosterone therapy tion trait treatment[books.google.com]
  • Treatment, which is experimental, must begin in the first several weeks of gestation. Treatment of nonclassic 21-hydroxylase deficiency depends on symptoms. If asymptomatic, no treatment is required.[msdmanuals.com]
  • Thrice daily oral hydrocortisone is the preferred treatment for CAH world over. [1], [2] In the absence of clear supporting evidence or guidelines most institutions follow their own treatment regimens.[ijem.in]

Prognosis

  • Our case illustrates the clinical significance to recognize this condition as it has a good long-term prognosis when adequate fludrocortisone replacement is instituted.[bmcendocrdisord.biomedcentral.com]
  • Life-long hormone replacement therapy (gluco- and mineralocorticoids for the classical forms with salt wasting, and glucocorticoids for the simple virilizing forms) requires close follow-up (pediatric through to adulthood) and has improved the prognosis[medicbind.com]

Etiology

  • Patients with aldosterone deficiency of any etiology may present with dehydration, hyponatremia, and hyperkalemia, especially with the stress of illness.[emedicine.medscape.com]
  • Role of 1,25 dihydroxyvitamin D3 (soltriol) in etiology and therapy of seasonal affective disorder and other mental processes. Psychopharmacology 1989; 97:285-294. 102. Sun X, Zemel MB.[dr-gahlen.de]

Epidemiology

  • Relevant External Links for CYP11B2 Genetic Association Database (GAD) CYP11B2 Human Genome Epidemiology (HuGE) Navigator CYP11B2 Atlas of Genetics and Cytogenetics in Oncology and Haematology: CYP11B2 No data available for Genatlas for CYP11B2 Gene Polymorphisms[genecards.org]
  • Epidemiology of cancer risk. Vitamin D and calcium. In: Vitamin D. Feldman D, Pike JW, Glorieux FH, ed. New York, Elsevier Press Inc. 2005:1617-1634. 7/9 39. Glerup H, Eriksen EF. Muscles and falls. In: Vitamin D. Feldman D, eds.[dr-gahlen.de]
Sex distribution
Age distribution

Pathophysiology

  • Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test The cause of congenital adrenal hyperplasia (CAH) is an inherited genetic defect that results in decreased formation of 1 of[mayomedicallaboratories.com]

Prevention

  • With illness, corticosteroid dosages are increased (typically doubled or tripled) to prevent adrenal crisis. Mineralocorticoid replacement is not adjusted.[msdmanuals.com]
  • In the second sibling, masculinization could be completely prevented by early prenatal dexamethasone treatment of the mother.[frontiersin.org]
  • Prenatal diagnosis is possible through molecular analysis of fetal DNA and allows treatment to be established for preventing virilization in affected females.[medicbind.com]
  • The goal of the treatment for adult patients is to improve the quality of life, promote fertility, prevent and treat long-term complications caused by glucocorticoid.[alliedacademies.org]
  • Prenatal dexamethasone use for the prevention of virilization in pregnancies at risk for classical congenital adrenal hiperplasia because of 21-hydroxylase (CYP21A2) deficiency: a systematic review and meta-analyses.[revistas.fucsalud.edu.co]

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