Abstract
The occurrence of nodules in patients with adrenal enzymatic defects is reported in the literature, but its frequency and etiology are not clear. We studied 14 patients (10F, 4M) with congenital adrenal hyperplasia due to 21-hydroxylase deficiency with mean age 13,3y (2,4-36y). Two patients had the salt-losing form, 7 simple virilizing and 5 symptomatic non classic form. Image studies were carried out before treatment in 2 patients and after 1,4 to 14 y of therapy in 12 (mean 5,7y). Two had computed tomography and the other 12 magnetic resonance imaging. Treatment was classified according to 4 quarterly testosterone and adrostenedione measurements during the year before imaging in: (E) Excellent -all levels normal (1 case); (G) Good -one high value (4); (R) Regular -two high values (6); (P) Poor-three or more abnormal values(1). Both patients evaluated before therapy had enlarged adrenals one with 0.9 cm nodule that disappeared after one year of therapy; of the 12 patients studied during therapy 6 (50%) had an enlarged left adrenal and one patient with P control both adrenal enlarged and a 0,9 cm nodule in the L. adrenal. The patient with E control had normal adrenals and the patients with G and R controls had normal or enlarged adrenals. We conclude that adrenal enlargement and nodules are related to control suggesting an effect mediated by ACTH.
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Bachega, T., Mattielli, J., Madureira, G. et al. 3 ADRENAL IMAGE STUDIES IN PATIENTS WITH CONGENITAL ADRENAL HYPERLASIA DUE TO 21-HYDROXYLASE DEFICIENCY. Pediatr Res 36, 678 (1994). https://doi.org/10.1203/00006450-199411000-00061
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DOI: https://doi.org/10.1203/00006450-199411000-00061