title: [Feminine pseudo-hermaphroditism and ovarian polycystic syndrome: the role of hydrocortisone].
abstract: We report the case of a patient who was initially assigned as a male, and in whom the diagnosis of CAH was delayed (17 years of age). He was shown to have female pseudohermaphrodites. Before treatment, plasma testosterone level was: 15 ng/mL (N: 0.1-0.7), 17 OH progesterone (17 OHP): 45 ng/mL (N: 0.1-1.1) and FSH, LH values were below the normal range. While taking hydrocortisone, a rapid onset of new clinical, biological and radiological findings were observed after three months: rapid menarche and thelarche occurred, plasma testosterone and 17 OHP levels decreased, respectively 1 and 3.7 ng/mL, plasma FSH and LH were respectively 4.1 mUI/mL (N: 1.5-7) and 14.3 m UI/mL (N: 1.1-11.7). Polycystic ovaries were shown at sonography. Authors try to discuss the mechanism of the new events observed and specially those related to the polycystic ovarian disease. In a female with untreated CAH at adult age, menarche can rapidly occur once appropriate treatment was started.
authors.affiliation: Service de médecine interne, hôpital Fattouma Bourguiba, Monastir, Tunisie. kacem_maha@yahoo.fr
authors.forename: M
authors.initials: M
authors.lastname: Kacem
authors.forename: M
authors.initials: M
authors.lastname: Said
authors.forename: S Ben
authors.initials: SB
authors.lastname: Kacem
authors.forename: F Haj
authors.initials: FH
authors.lastname: Youssef
authors.forename: S
authors.initials: S
authors.lastname: Mahjoub
authors.forename: M
authors.initials: M
authors.lastname: Elmay
mesh_terms: D019326:17-alpha-Hydroxyprogesterone / Q000097:blood; D000293:Adolescent; D001940:Breast / Q000187:drug effects / Q000254:growth & development; D012734:Disorders of Sex Development / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D012739:Gonadal Steroid Hormones / Q000097:blood*; D006801:Humans; D006854:Hydrocortisone / Q000627:therapeutic use*; D007986:Luteinizing Hormone / Q000097:blood; D008572:Menarche / Q000187:drug effects*; D011085:Polycystic Ovary Syndrome / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology; D013739:Testosterone / Q000097:blood; D014463:Ultrasonography
chemical_list: D012739:Gonadal Steroid Hormones; D013739:Testosterone; D019326:17-alpha-Hydroxyprogesterone; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone; D006854:Hydrocortisone