Objective: To present four cases of Hirsutism due to a late-starting deficit of Hydroxylase-21.
Design: Retrospective, descriptive study.
Setting: Primary Care team.
Patients and others participants: Four women (21, 22, 32 and 36 years old) were studied because they presented hirsutism.
Measurements and main results: All the patients had begun to be hirsute at puberty. Three had regular cycles and one, irregular. Two women (32 and 36) had had various children. In all the cases the hirsutism was moderate. One woman suffered severe acne. Basal testosterone was only high in one case; DHEA-S in two. The values of basal 17-OH-Progesterone were high in three women. The ACTH stimulation test showed positive for three patients: it was not performed on the fourth due to her very high levels of 17-OH-Progesterone.
Conclusions: Late-starting Hydroxylase-21 deficit is a frequent cause of hirsutism in Primary Care. It must be considered and investigated as a cause when faced with a clinical picture compatible with benign hirsutism, in order to advise the woman on the best treatment and avoid iatrogenic attitudes.