Congenital Adrenal Hyperplasia due to 21 Hydroxylase deficiency. A case report.
Abstract
A patient with congenital adrenal hyperplasia by deficit of 21-Hydroxylase is presented; she was the first patient detected by neonatal screening program in Ciego de Avila, that allow an early diagnosis and opportune treatment and avoided a fatal outcome during the adrenal crisis. The incidence in the caucasian population is 1/12000. This patient presents consanguinity familiar antecedents and the diagnosis suggests the presence of ambiguous genitals (Prader IV) at the time of delivery, the adrenal crisis initiate in the thirteenth day of life, characterized by a curve of weight flat, vomits, irritability, pale skin, livedo reticularis; the complementaries show: 17OH progesterone 97 nmol/L in two occasions; oral chromatin 25%; ionogram: Na+ 120 mmol/L., K+ 6.5 mmol/L; gasometry: PH 7.26, PO2 45.3 mmHg, ABE -8.2 mmol/L, PCO2 41.7 mmHg, sO 77.0% y SBC 17.5 mmol/L. In her sixth day of life this patient received treatment with prednisona at the rate of 5mg/SC/day; later, Fludrocortisone 0.05mg/24h was included.Downloads
References
Güell R. Hiperplasia adrenal congénita. En: Güell R. Temas de Endocrinología Infantil. La Habana: Instituto Cubano del Libro; 1974. p. 151-88.
Espinosa Reyes TM, Hernández Benítez M, Carvajal Martínez F, González Reyes E, Domínguez Alonso E. Influencia de factores perinatales en la pesquisa neonatal de hiperplasia adrenal congénita en Ciudad de La Habana y La Habana. Rev Cubana Endocrinol [Internet]. 2012 [citado 11 Jul 2012]; 23(1): 1-18. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1561-29532012000100001&lng=es
Soriano GL, Velázquez de Cuéllar PM. Hiperplasia suprarrenal congénita. Rev Pediatr Integr. 2007; 11(7):601-10.
Grumbach MM, Hughes LA, Conte FA. Trastornos de la diferenciación sexual. En: Kronenberg HM, Shlomo M, Polonsky KS, Reed Larsen P. Williams. Tratado de Endocrinología. 10ª ed. Madrid: Elservier; 2006. p. 917-1054.
Rodríguez Arnao MD, Rodríguez A, Badillo K, Velasco A, Dulín E, Ezquieta B. Déficit de 21-hidroxilasa: aspectos actuales. Endocrinol Nutr. 2006; 53(2): 124-36.
American Academy of Pediatrics. Technical report: congenital adrenal hyperplasia. Pediatrics. 2000; 106: 1511-8.
White PC, Spenser PW. Congenital adrenal hyperplasia due to 21-hydroxylase deficiency. Endocrinol Rev. 2000; 21: 245-91.
Merke DP, Bernnstein SR. Congenital adrenal hyperplasia. Lancet. 2005; 365: 2125-36.
Ezquieta B, Ruano MLF, Dulín E, Arnao MDR, Rodríguez A. Estimación de la prevalencia de enfermedades recesivas frecuentes mediante análisis de ADN en muestra del cribado neonatal. Med Clín (Barc). 2005; 1255: 493-5.
Stewart PM. Adrenal cortex. En: Reed PL, Kronenberg HM, Melmed S, Polonsky K. Williams Textbook of Endocrinology. 10 ed. Washington: Faith Vait. 2002. p. 491-542.
Grumbach MM, Conte FA. Disorders of sex differentiation. En: Wilson JD, Foster DW, Kronenberg HM, Larsen PR. Williams Textbook of Endocrinology. 9 ed. Philadelphia: Saunders; 1998. p. 1303-425.
González Fernández P, Quesada Dorta M, Cabrera Panizo R, Bello Álvarez D. Disgenesia gonadal mixta con fórmula cromosómica 45,X/46,X, (mar). Presentación de una paciente. Rev Cubana Endocrinol [Internet]. 2002 [citado 20 Ene 2013]; 13(3): [aprox. 8 p.]. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1561-29532002000300007&lng=es&nrm=iso
Baumgartne Parzer SM, Nowotny P, Hainze G, Waldausl W, Vierhapper H. Carrier frequency of congenital adrenal hyperplasia (21-hydroxylase deficiency) in a middle european population. J Clin Endocrinol Metab. 2005; 90: 775-8.
Hingre RV, Gross SJ, Hingre KS. Adrenal steroidogenesis in very low birth weight preterm infants. J Clin End Metab. 2005; 10: 1210-33.
Downloads
Published
How to Cite
Issue
Section
License
Those authors who have publications with this journal accept the following terms of the License CC Attribution-NonCommercial 4.0 International (CC BY-NC 4.0):
You are free to:
- Share — copy and redistribute the material in any medium or format
- Adapt — remix, transform, and build upon the material
- The licensor cannot revoke these freedoms as long as you follow the license terms.
Under the following terms:
- Attribution — You must give appropriate credit , provide a link to the license, and indicate if changes were made . You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- NonCommercial — You may not use the material for commercial purposes .
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
Notices:
You do not have to comply with the license for elements of the material in the public domain or where your use is permitted by an applicable exception or limitation .
No warranties are given. The license may not give you all of the permissions necessary for your intended use. For example, other rights such as publicity, privacy, or moral rights may limit how you use the material.