Prevalence of late-onset adrenal hyperplasia in postmenarchal hirsutism.
The response of plasma 17-hydroxyprogesterone (17-OHP) to exogenous ACTH was investigated in 85 consecutive women referred for postmenarchal hirsutism, in order to assess the prevalence of late-onset adrenal hyperplasia due to 21-hydroxylase deficiency and its relevance to the clinical practice. An exaggerated response of plasma 17-OHP to ACTH, indicating 21-hydroxylase deficiency, was found in only one patient with a prevalence of 1.1%. The patient with late-onset adrenal hyperplasia presented signs of virilism and had high basal levels of 17-OHP. On the basis of our results, late-onset adrenal hyperplasia accounts for a very small proportion of cases of hirsutism; moreover, from this and previous studies it is apparent that the determination of basal plasma 17-OHP may be sufficient to discover late-onset 21-hydroxylase deficiency. Therefore, we do not consider ACTH testing an advisable step in the routine screening for hirsutism.
Motta
P
P
Clinica Medica I, Università di Milano, Italy.
Catania
A
A
Airaghi
L
L
Mangone
I
I
Cantalamessa
L
L
Zanussi
C
C
D000293:Adolescent; D000311:Adrenal Glands / Q000473:pathology*; D000324:Adrenocorticotropic Hormone / Q000494:pharmacology; D000328:Adult; D002648:Child; D005260:Female; D006628:Hirsutism / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D006908:Hydroxyprogesterones / Q000097:blood; D006965:Hyperplasia / Q000209:etiology / Q000473:pathology; D008403:Mass Screening / Q000379:methods
D006908:Hydroxyprogesterones; D000324:Adrenocorticotropic Hormone