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Hiperplasia suprarrenal congénita

Authors: Francisco Núñez León; Alfredo Jácome Roca;

Hiperplasia suprarrenal congénita

Abstract

*Este trabajo fue presentado en el IX Congreso Panamericano de Endocrinología, Quito, Diciembre de 1978. Siete niños con Hiperplasia suprarrenal congénita fueron estudiados en un período de 10 años. 5 eran de sexo femenino, 2 del masculino; los dos hombres eran hermanos. Una de las niñas falleció en el período neonatal, encontrándosele suprarrenales de aspecto cerebroide, hiperplásicas. Todos los pacientes presentaban deficiencia de 21-hidroxilasa. El diagnóstico se hizo sobre la base de virilización con velo pubiano e hipertrofia clitoridiana en las niñas y macrogenitosomia precoz en los dos niños, aumento en la estatura con excesiva maduración ósea, elevación de los 17-CS urinarios, buena supresión con la administración oral de betametasona, valores urinarios bajos de 17-0HCS; excreción aumentada de pregnanetriol en dos pacientes y testosterona plasmática elevada en uno, a quienes se les practicaron estos exámenes. La cromatina sexual y cariotipo estuvieron acordes con el sexo asignado. Las anomalías asociadas fueron restos mullerianos con ausencia de utero en una y desembocadura vaginal en la uretra en dos. El tratamiento consistió en clitoridectomía y supresión con glucocorticoides, obteniéndose control de la enfermedad en todos y presencia de menstruaciones normales en dos. La hiperplasia suprarrenal congénita por deficiencia de la 21-hidroxilasa es una enfermedad autosómica recesiva, se ha observado en grupos de hermanos y en gemelos idénticos, y el gene responsable por la deficiencia enzimatica está estrechamente ligado al HLA. Esta deficiencia produce disminución de la síntesis de cortisol, aumento del ACTH, hiperplasia y aumento de los andrógenos suprarrenales, los cuales causan la virilización que se observa. SUMMARY Congenital adrenal hyperplasia, hormonal and morphologic evaluation of seven cases Seven children with congenital adrenal hiperplasia were studied over a period of 10 years, 5 were females and 2 males; the two boys were brothers. One of the girls died in the neonatal period and autopsy showed hyperplastic adrenal glands of cerobroid aspect. All patients had deficiency of 21-hidroxylase. Diagnosis was made on the basis of virilization with public hair and clitoris hypertrophy in girls, macrogenitosomia praecox in boys, increased height, excesive bone maturation, increase in urinary 17-KS, good supression of them with oral administration of betamethasone, low urinary values of 17-OHCS, increased excretion of urinary pregnanetriol in 2 patients, increased plasma testosterone in one, to whom these test were performed. Sex chromatine and kariotype were in agreement with assigned sex. Associated anomalies were mullerian rests with uterus abscence in one, urethra ending in vagina in two. Treatment was clitoridectomy and permanent supression with glucocorticoids; control of the disease was attained in all, two girls that reached pubertal age had normal menses. Congenital adrenal hyperplasia due to deficiency of 21-hydroxilase is a recessive autosomic disease, observed in groups of brothers and in identical twins, being the gene responsible for enxymatic deficiency closely linked to HLA. This deficiency produces decrease in cortisol synthesis, increase in ACTH production. hyperplasia and increase in adrenal androgens, causing these changes the observed signs of virilization.

Keywords

Hiperplasia suprarrenal congénita, RC648-665, Diseases of the endocrine glands. Clinical endocrinology, IX Congreso Panamericano de Endocrinología

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
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