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17α-hydroxylase/17,20-lyase deficiency in congenital adrenal hyperplasia: A case report

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单位: [1]Huazhong Univ Sci & Technol, Tongji Hosp, Dept Endocrinol, Tongji Med Coll, 1095 Jiefang Ave, Wuhan, Hubei 430030, Peoples R China
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关键词: 17 alpha-hydroxylase/17 20-lyase deficiency congenital adrenal hyperplasia gene mutation primary amenorrhea

摘要:
Congenital adrenal hyperplasia (CAH) is a rare autosomal recessive disorder caused by mutations in the cytochrome P450 family 17 subfamily A member 1 (CYP17A1) gene located on chromosome 10q24.3, which leads to a deficiency in 17 alpha-hydroxylase/17,20-lyase. The disorder is characterized by low blood levels of estrogens, androgens and cortisol, which leads to a compensatory increase in adrenocorticotropic hormone levels that stimulate the production of mineralocorticoid precursors. This subsequently leads to hypertension, hypokalemia, primary amenorrhea and sexual infantilism. Over 90 distinct genetic lesions have been identified in patients with this disorder. The prevalence of common mutation of CYP17A1 gene differs among ethnic groups. Treatment of this disorder involves replacement of glucocorticoids and sex steroids. Estrogen alone is prescribed for patients who are biologically male with 17 alpha-hydroxylase deficiencies that identify as female. However, genetically female patients may receive estrogen and progesterone supplementation. In the present study, a 17-year-old female with 17 alpha-hydroxylase/17,20-Iyase deficiency that presented with primary amenorrhea and sexual infantilism and no hypertension, was examined. The karyotype of the patient was 46, XX, and genetic analysis revealed the presence of a compound heterozygous mutation in exons 6 and 8, leading to the complete absence of 17 alpha-hydroxylase/17,20-Iyase activity. The patient was treated with prednisolone and ethinyl estradiol. In addition, a summary of the recent literature regarding CAH is presented.

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出版当年[2016]版:
大类 | 4 区 医学
小类 | 4 区 医学:研究与实验 4 区 肿瘤学
最新[2025]版:
大类 | 4 区 医学
小类 | 4 区 医学:研究与实验 4 区 肿瘤学
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出版当年[2015]版:
Q3 MEDICINE, RESEARCH & EXPERIMENTAL Q4 ONCOLOGY
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Q2 MEDICINE, RESEARCH & EXPERIMENTAL Q2 ONCOLOGY

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第一作者单位: [1]Huazhong Univ Sci & Technol, Tongji Hosp, Dept Endocrinol, Tongji Med Coll, 1095 Jiefang Ave, Wuhan, Hubei 430030, Peoples R China
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