Congenital adrenal hyperplasia classification: Difference between revisions

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{{Congenital adrenal hyperplasia}}
{{Congenital adrenal hyperplasia}}
==Classification==
Congenital adrenal hyperplasia is classified into seven types based on the genetic causes that lead to hyperplasia and hormonal imbalance.
{| align="center" class="wikitable" style="border: 0px; font-size: 90%; margin: 3px;"
! align="center" style="background:#DCDCDC;" rowspan="2" colspan="2" |Disease
! align="center" style="background:#DCDCDC;" colspan="2" |History and symptoms
! align="center" style="background:#DCDCDC;" colspan="2" |Laboratory findings
! align="center" style="background:#DCDCDC;" |Defective gene
|-
!Blood pressure
!Genitalia
!
!K levels
!
|-
| align="center" style="padding: 5px 5px; background: #DCDCDC;" rowspan="2" |[[21-hydroxylase deficiency]]
|Classic type
|
* Low in salt-wasting
* Normal in non-salt-wasting
|
* Female: ambiguous
* Male: normal or scrotal pigmentation and large phallus 
|
Increased:
* 17-OHP
* Progesterone
* Androstenedione
* DHEA
Decreased:
* Aldosterone
* Corticosterone (salt-wasting)
* Cortisol (simple virilizing)
|
* High in salt wasting type
* Normal in non salt wasting
|
* CYP21A1 and CYP21A2 gene
|-
|Non-classic type
|
* Normal
|
* Female: virilization after puberty
* Male: normal appearance
|Increased:
* 17-OHP
* Exaggerated androstene-dione, DHEA, and 17-OHP
response to ACTH
|
* Normal
|
* CYP21A1 and CYP21A2 gene
|-
| align="center" style="padding: 5px 5px; background: #DCDCDC;" colspan="2" |17a-Hydroxylase deficiency
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |
* Hypertension
|
* Female: normal
* Male: ambiguous
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |
* Increased DOC, corticosterone
* Decreased 17OH-steroids, cortisol, aldosterone, androgens and estrogens
|
* Low
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |
* ''CYP17A1''
|-
| align="center" style="padding: 5px 5px; background: #DCDCDC;" colspan="2" |11β-hydroxylase deficiency
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |
* Hypertension
|
* Female: ambiguous
* Male: normal or scrotal pigmentation and large phallus
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |
* Indreased DOC, 11-deoxycortisol
* Decreased corticosterone, cortisol,  aldosterone,  androgens
|
* Low
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |
* ''CYP11B1''
|-
| align="center" style="padding: 5px 5px; background: #DCDCDC;" colspan="2" |3-beta-hydroxysteroid dehydrogenase
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |
|
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Increased:
* DHEA
* 17-OH pregneno-lone
* Pregnenolone
Decreased:
* Cortisol
* Aldosterone
|
* High
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |
|-
| align="center" style="padding: 5px 5px; background: #DCDCDC;" colspan="2" |Cytochrome P450-oxidoreductase (POR) deficiency (ORD)
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |
|
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |
|
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |
|-
| align="center" style="padding: 5px 5px; background: #DCDCDC;" colspan="2" |Congenital lipoid adrenal hyperplasia
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |
|
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |
|
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |
|-
| align="center" style="padding: 5px 5px; background: #DCDCDC;" colspan="2" |Cholesterol side-chain cleavage enzyme deficiency
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |
|
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |
|
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |
|}

Revision as of 15:58, 26 July 2017

Congenital adrenal hyperplasia main page

Overview

Classification

21-hydroxylase deficiency
11β-hydroxylase deficiency
17 alpha-hydroxylase deficiency
3 beta-hydroxysteroid dehydrogenase deficiency
Cytochrome P450-oxidoreductase (POR) deficiency (ORD)
Lipoid congenital adrenal hyperplasia

Differential Diagnosis

Classification

Congenital adrenal hyperplasia is classified into seven types based on the genetic causes that lead to hyperplasia and hormonal imbalance.

Disease History and symptoms Laboratory findings Defective gene
Blood pressure Genitalia K levels
21-hydroxylase deficiency Classic type
  • Low in salt-wasting
  • Normal in non-salt-wasting
  • Female: ambiguous
  • Male: normal or scrotal pigmentation and large phallus

Increased:

  • 17-OHP
  • Progesterone
  • Androstenedione
  • DHEA

Decreased:

  • Aldosterone
  • Corticosterone (salt-wasting)
  • Cortisol (simple virilizing)
  • High in salt wasting type
  • Normal in non salt wasting
  • CYP21A1 and CYP21A2 gene
Non-classic type
  • Normal
  • Female: virilization after puberty
  • Male: normal appearance
Increased:
  • 17-OHP
  • Exaggerated androstene-dione, DHEA, and 17-OHP

response to ACTH

  • Normal
  • CYP21A1 and CYP21A2 gene
17a-Hydroxylase deficiency
  • Hypertension
  • Female: normal
  • Male: ambiguous
  • Increased DOC, corticosterone
  • Decreased 17OH-steroids, cortisol, aldosterone, androgens and estrogens
  • Low
  • CYP17A1
11β-hydroxylase deficiency
  • Hypertension
  • Female: ambiguous
  • Male: normal or scrotal pigmentation and large phallus
  • Indreased DOC, 11-deoxycortisol
  • Decreased corticosterone, cortisol, aldosterone, androgens
  • Low
  • CYP11B1
3-beta-hydroxysteroid dehydrogenase Increased:
  • DHEA
  • 17-OH pregneno-lone
  • Pregnenolone

Decreased:

  • Cortisol
  • Aldosterone
  • High
Cytochrome P450-oxidoreductase (POR) deficiency (ORD)
Congenital lipoid adrenal hyperplasia
Cholesterol side-chain cleavage enzyme deficiency