Background. 17-Hydroxylase (17-OH) deficiency syndrome is a rare genetic disorder of steroid biosynthesis that causes decreased production of glucocorticoids and sex steroids and increased synthesis of mineralocorticoid precursors.
Hormone imbalances lead to the characteristic signs and symptoms of 17α-hydroxylase/17,20-lyase deficiency, which include high blood pressure (hypertension), low levels of potassium in the blood (hypokalemia), and abnormal sexual development. The severity of the features varies.
Contrary to expectations, 21-OH deficiency doesn't result in inadequate virilization; instead, it causes increased androgen levels, leading to advanced bone age and premature puberty. On the other hand, males affected by 17-OH deficiency often present with atypical genitalia due to androgen synthesis deficits.
Low aldosterone levels in patients with 17OHD are thought to be due to 11-deoxycorticosterone and corticosterone because the mineralocorticoid effects of both steroids suppress the activity of the renin-angiotensin-aldosterone system [4].
Females with the non-classic type of 21-hydroxylase deficiency have female-typical genitalia. As affected females get older, they may experience hirsutism, male pattern baldness, irregular menstruation, and decreased fertility. Males with the non-classic type may have early beard growth and small testes.
17-OH progesterone is a blood test that measures the amount of 17-OH progesterone in the blood. This is a hormone produced by the adrenal glands and sex glands.
21-hydroxylase deficiency is an autosomal recessive disorder caused by a deficiency in one of the enzymes required for the synthesis of cortisol in the adrenal glands. 21-Hydroxylase deficiency is the most common cause of congenital adrenal hyperplasia but can be a challenge to diagnose and treat.
Virilization is a condition in which a female develops characteristics associated with male hormones (androgens), or when a newborn has characteristics of male hormone exposure at birth.
17-Hydroxylase deficiency is a rare cause of congenital adrenal hyperplasia (CAH), accounting for less than 1% of cases and occurring in 1 in 50,000 people globally. Over 90% of individuals with CAH have 21-hydroxylase deficiency. The incidence of classic 21-hydroxylase deficiency affects 1 in 16,000 live births.
The degree of elevation in 17-hydroxyprogesterone will often hint at the underlying diagnosis. If the 17-hydroxyprogesterone level is markedly elevated (>10,000 ng/dL), the diagnosis of classic CAH is likely, whereas levels >2000 ng/dL but <10,000 ng/dL typically reflect non-classic disease (11••).
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