Congenital adrenal hyperplasia due to 11-Beta-hydroxylase deficiency in a Tunisian family

Pan Afr Med J. 2020 Jul 28:36:226. doi: 10.11604/pamj.2020.36.226.24270. eCollection 2020.

Abstract

Congenital adrenal hyperplasia refers to a group of rare genetic disorders affecting the adrenal glands. 21-hydroxylase deficiency is the most prevalent and the most studied cause while the remaining enzymatic defects are less common, accounting for less than 10% of cases. We herein described the clinical, biological and molecular characteristics and outcome of patients of the same family diagnosed with 11-Beta-hydroxylase deficiency. The disorder was revealed by peripheral precocious puberty between the age of 2-3 years in males and by the virilization of the external genitalia in females. Genetics finding a homozygous p.Gly379Val mutation in the CYP11B1 gene. All patients received hydrocortisone supplementation therapy and mineralocorticoid-receptor antagonist. The females underwent a surgical correction of the ambiguous genitalia at the neonatal age. Long term follow-up revealed metabolic syndrome, obesity and hypertension in the first two patients, an impaired final height in the two females and hypokalemia in three patients.

Keywords: 11-beta-hydroxylase deficiency; Adrenal hyperplasia; congenital; hypertension; hypokalemia; metabolic syndrome.

Publication types

  • Case Reports

MeSH terms

  • Adrenal Hyperplasia, Congenital / diagnosis*
  • Adrenal Hyperplasia, Congenital / genetics
  • Adrenal Hyperplasia, Congenital / physiopathology
  • Adult
  • Child
  • Female
  • Follow-Up Studies
  • Humans
  • Hydrocortisone / administration & dosage
  • Male
  • Mineralocorticoid Receptor Antagonists / administration & dosage
  • Mutation
  • Puberty, Precocious / etiology
  • Steroid 11-beta-Hydroxylase / genetics*
  • Tunisia

Substances

  • Mineralocorticoid Receptor Antagonists
  • Steroid 11-beta-Hydroxylase
  • Hydrocortisone

Supplementary concepts

  • Congenital adrenal hyperplasia due to 11-Beta-hydroxylase deficiency