Kalani Amir, Bahtiyar Gul, Sacerdote Alan
Department of Internal Medicine, Woodhull Medical Center, Brooklyn, New York, USA.
BMJ Case Rep. 2012 Sep 17;2012:bcr2012006989. doi: 10.1136/bcr-2012-006989.
Congenital adrenal hyperplasia (CAH) is a well-characterised family of disorders of the adrenal cortices, resulting in varying degrees of cortisol, aldosterone and androgen deficiency or androgen excess, depending on the enzyme(s) affected and the degree of quantitative or functional enzyme deficit. Withania somnifera (WS), commonly known as Ashwagandha, is a medicinal plant that has been employed for centuries in ayurvedic medicine. Preclinical studies have shown that WS increases circulating cortisol levels and improves insulin sensitivity. We report the case of a 57-year-old woman with non-classical adrenal hyperplasia due to both 3-β-ol dehydrogenase deficiency and aldosterone synthase deficiency who was self-treated with WS for 6 months. After 6 months of treatment her serum 18-OH-hydroxycorticoserone, 17-OH-pregnenolone, corticosterone and 11-deoxycortisol decreased by 31%, 66%, 69% and 55%, respectively. The biochemical improvement was accompanied by a noticeable reduction in scalp hair loss.
先天性肾上腺皮质增生症（CAH）是一类特征明确的肾上腺皮质疾病，根据受影响的酶以及定量或功能性酶缺乏的程度，会导致不同程度的皮质醇、醛固酮和雄激素缺乏或雄激素过量。南非醉茄（WS），俗称印度人参，是一种药用植物，在阿育吠陀医学中已使用了数百年。临床前研究表明，南非醉茄可提高循环皮质醇水平并改善胰岛素敏感性。我们报告了一例57岁女性病例，该患者因3-β-羟类固醇脱氢酶缺乏和醛固酮合酶缺乏导致非经典肾上腺皮质增生症，自行服用南非醉茄6个月。治疗6个月后，她的血清18-羟基皮质酮、17-羟孕烯醇酮、皮质酮和11-脱氧皮质醇分别下降了31%、66%、69%和55%。生化指标的改善伴随着头皮脱发明显减少。
