Female pseudohermaphroditism: Congenital adrenal hyperplasia presenting with diffuse hyperpigmentation

Authors

  • Wajieha Saeed
  • Ghazala Butt
  • Khawar Khurshid

Keywords:

Pseudohermaphroditism, congenital adrenal hyperplasia, androgens

Abstract

The term congenital adrenal hyperplasia (CAH) comprises a group of autosomal recessive disorders, each of which involves a deficiency of an enzyme involved in the synthesis of cortisol, aldosterone, or both. The clinical presentation varies according to chromosomal sex. The sex of neonate with CAH is often initially unclear because of genital ambiguity. We report a case of 25-year-old phenotypically male, presenting with generalized hyperpigmentation for 5 years and occasional syncope for 1 year. On examination there were sparse axillary and pubic hair with ambiguous genitalia. 46XX karyotype, hypoplastic uterus on CT scan and elevated ACTH and 17-hydroxyprogesterone levels lead to the diagnosis of female pseudohermaphroditism due to congenital adrenal hyperplasia and patient was started on glucocorticoids and fludrocortisone by endocrinologist and was also referred to plastic surgeon.

References

Meske DP, Bornstein SR, Avila NA, chrousos GP. Future directions in the study and management of congenital adrenal hyperplasia due to 21-hydroxylase deficiency. Ann Intern Med 2002;136:320-34.

Kim CJ, Lin L, Huang N, Quigley CA, AvRuskin TW , Achermann JC, et al. Severe combined adrenal and gonadal deficiency caused by novel mutations in the cholesterol side chain cleavage enzyme, P450 sec. J clin endocrinol metab 2008; 93:696-702.

Aubrey M, Jeff M. Genetic disorders and the fetus: Diagnosis, Prevention and treatment. European Journal of Endocrinology 2010;167:103-110.

Swaminathan D. Adrenogenital syndrome. Indian pediatrics 2005;42:73-74.

Richard D, McAnulty M, Michele B. Sex and sexuality. vol 1. Greenwood Publishing Group 2006; P:165.

Wilkins L. Abnormal sex differentiation: Hermaphroditism and Gonadal Dysgenesis. Engl J Med 1996; 74:297-308.

Kivi R. Congenital Adrenal Hyperplasia [Internet]. Healthline. 2016 (cited 26 April 2016). Available from: http://www.healthline.com/health/congenital-adrenal-hyperplasia.

Cabrera M, Vogiatzi M, New M. Long term outcome in adult males with classic congenital adrenal hyperplasia. J Clin Endocrinol Metab 2001;86: 304-56.

Loche S, New M. Congenital adrenal hyperplasia: female pseudohermaphroditism and Virilization. Glob Libr Women’s Med. (ISSN: 1756-2228); 2008; DOI 10.3843/GLOWM.10348.

Dreger V, Alice, Ellen K, Feder AT. Prenatal dexamethasone for congenital adrenal hyperplasia. Journal of Bioethical Inquiry 2012; 9:277-294.

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Published

2018-12-13

How to Cite

1.
Saeed W, Butt G, Khurshid K. Female pseudohermaphroditism: Congenital adrenal hyperplasia presenting with diffuse hyperpigmentation. J Pak Assoc Dermatol [Internet]. 2018Dec.13 [cited 2024Dec.5];28(2):262-5. Available from: https://jpad.com.pk/index.php/jpad/article/view/1171

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Section

Case Reports

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