title: [Hirsutism due to a late-onset of hydroxylase-21 deficit: apropos of 4 cases].
abstract: OBJECTIVE
  To present four cases of Hirsutism due to a late-starting deficit of Hydroxylase-21.
  
  
  METHODS
  Retrospective, descriptive study.
  
  
  METHODS
  Primary Care team.
  
  
  METHODS
  Four women (21, 22, 32 and 36 years old) were studied because they presented hirsutism.
  
  
  RESULTS
  All the patients had begun to be hirsute at puberty. Three had regular cycles and one, irregular. Two women (32 and 36) had had various children. In all the cases the hirsutism was moderate. One woman suffered severe acne. Basal testosterone was only high in one case; DHEA-S in two. The values of basal 17-OH-Progesterone were high in three women. The ACTH stimulation test showed positive for three patients: it was not performed on the fourth due to her very high levels of 17-OH-Progesterone.
  
  
  CONCLUSIONS
  Late-starting Hydroxylase-21 deficit is a frequent cause of hirsutism in Primary Care. It must be considered and investigated as a cause when faced with a clinical picture compatible with benign hirsutism, in order to advise the woman on the best treatment and avoid iatrogenic attitudes.
authors.affiliation: Contros de Salud de Sárdoma, Vigio.
authors.forename: F
authors.initials: F
authors.lastname: Lago Deibe
authors.forename: F J
authors.initials: FJ
authors.lastname: García Soidán
mesh_terms: D000312:Adrenal Hyperplasia, Congenital; D000328:Adult; D005260:Female; D006628:Hirsutism / Q000209:etiology*; D006801:Humans
vernacular_title: Hirsutismo por déficit de 21-hidroxilasa de comienzo tardío: a propósito de cuatro casos.