Non-classic adrenal hyperplasia, laboratory characteristics and treatment response. Cohort study
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Keywords

Adrenal Hyperplasia, Congenital
Steroid-21-Hydroxylase
17-alpha-Hydroxyprogesterone
Testosterone
Dehydroepiandrosterone
Hyperandrogenism
Adrenocorticotropic Hormone

How to Cite

Abreu Lomba , A., González Bermúdez, C., Salazar, L., Bolena Muriel , A., Gómez, M., & Hernández-Carrillo, M. (2021). Non-classic adrenal hyperplasia, laboratory characteristics and treatment response. Cohort study. Revista Endocrino, 7(4), 236–242. https://doi.org/10.53853/encr.7.4.649

Abstract

Objective: To compare the laboratory characteristics and response to treatment in a cohort of patients with non-classical congenital adrenal hyperplasia followed during 12 months.

Methods: A study was conducted in a cohort of 38 patients with non-classical adrenal hyperplasia from January 2006 to December 2016. The characteristics of the study population and the response of 17-hydroxyprogesterone (17-OH progesterone), testosterone, and dehydroepiandrosterone sulfate (DHEA-S) are reported 6 and 12 months after treatment with dexamethasone, and ethinyl estradiol/cyproterone acetate. A multiple linear regression analysis was performed in order to explain the change of the outcome variables (17-OH progesterone, testosterone, and DHEA-S), adjusted according to body mass index (BMI) and age as covariates.

Results: The average age of the participants was 25 years and average BMI was 28.3 kg/m2. The most prevalent clinical features were acne (52.6%) and oligomenorrhea (55%). Hirsutism occurred to some degree in all cases (31.6% moderate and 39.5% severe, according to the Ferriman-Gallwey scale). The change in the levels of each hormone reflected a significant decrease in the median and interquartile range levels of 17-OH progesterone, testosterone and DHEA-S, at 6 and 12 months (p <0.05). In the multiple linear regression, the levels of testosterone showed variation according to BMI (p = 0.04). In this study, pharmacological therapy with dexamethasone was applied at different doses and all patients were given contraceptives, with adequate clinical and paraclinical response at 1 year of follow-up.

Conclusion: This study suggests that the combination of cyproterone plus ethinyl estradiol with variable doses of dexamethasone decreases the androgenic profile in patients with non-classic adrenal hyperplasia followed over a 1-year period.

https://doi.org/10.53853/encr.7.4.649
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