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[17α-羟化酶缺乏症的诊断与治疗:1例报告并文献复习]

[Diagnosis and treatment of 17 alpha-hydroxylase deficiency: a case report and literature review].

作者信息

Zhang Lin, Wang Hai ning, Hong Tian pei

机构信息

Department of Endocrinology, Peking University Third Hospital, Beijing 100083, China.

出版信息

Beijing Da Xue Xue Bao Yi Xue Ban. 2008 Apr;40(2):221-2.

Abstract

A 16-year-old "female" patient presented as hypertension, hypokalemia, male pseudohermaphroditism, lowered gonadal steroids and cortisol, elevated adrenocorticotropic hormone and pituitary gonadotropin, and 46 XY karyotype. The patient was diagnosed as 17 alpha-hydroxylase deficiency, a rare case of congenital adrenal hyperplasia. "She" chose to remain female appearance and social gender after negotiation with the parents. Cryptor-chidism of both inguinal canals was surgically removed for preventing canceration. After the surgery, a very small daily dose of dexamethasone (0.187 5 mg at bedtime) was enough to control hypertension and hypokalemia, and the therapy of conjugated estrogens (Premarin) was given to promote the development of female characters. After 6 months of treatment, normotension and normokalemia remained, and pubarche and mammogenesis emerged.

摘要

一名16岁的“女性”患者表现为高血压、低钾血症、男性假两性畸形、性腺类固醇和皮质醇水平降低、促肾上腺皮质激素和垂体促性腺激素升高,核型为46 XY。该患者被诊断为17α-羟化酶缺乏症,这是一种罕见的先天性肾上腺增生病例。经与父母协商,“她”选择保持女性外貌和社会性别。双侧腹股沟隐睾经手术切除以预防癌变。术后,每日小剂量的地塞米松(睡前0.187 5毫克)足以控制高血压和低钾血症,并给予结合雌激素(倍美力)治疗以促进女性特征发育。治疗6个月后,血压和血钾恢复正常,出现了阴毛生长和乳房发育。

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