Prevalence of nonclassical congenital adrenal hyperplasia among women self-referred for electrolytic treatment of hirsutism

A. A. Killeen, N. Q. Hanson, R. Eklund, C. J. Cairl, J. H. Eckfeldt

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4 Scopus citations

Abstract

Nonclassical congenital adrenal hyperplasia (NCCAH) is well recognized among women who seek medical attention for hirsutism. However, the prevalence of this disorder among women self-referred for electrolytic treatment of hirsutism is unknown. We hypothesized that the prevalence of NCCAH among women attending an electrolysis clinic might be high. By measuring the morning salivary 17-hydroxyprogesterone (17-OHP) as a screening test for NCCAH in 46 women in the follicular phase of their menstrual cycle, we identified 12 subjects with a high basal salivary 17-OHP. Eleven agreed to have a 60-minute Cosyntropin-stimulation test, as did an additional 6 of 9 women with normal basal salivary 17-OHP, but with a particularly high hirsutism score. One of the women with high basal salivary 17-OHP had a 60- minute Cosyntropin response, which was diagnostic of NCCAH. She was of the Ashkenazi Jewish decent, a group previously reported to have a high prevalence of NCCAH. A second woman with high salivary 17-OHP had a Cosyntropin-stimulation response consistent with heterozygosity for 21- hydroxylase deficiency. None of the Cosyntropin-stimulation responses in those chosen for a high hirsutism score were diagnostic. Thus, 1 of 46 (2.2%) of the women who entered our study had unrecognized NCCAH, a prevalence only about 2-fold greater than that reported in the general population. Therefore, we recommend that electrolysis clinics advise clients from ethnic groups known to have a high frequency of NCCAH of the advisability of having a formal medical evaluation for NCCAH.

Original languageEnglish (US)
Pages (from-to)197-200
Number of pages4
JournalAmerican Journal of Medical Genetics
Volume42
Issue number2
DOIs
StatePublished - Jan 1 1992

Keywords

  • 17-hydroxyprogesterone
  • congenital adrenal hyperplasia
  • electrolysis
  • hirsutism
  • laboratory diagnosis
  • prevalence
  • steroid 21-hydroxylase

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