Congenital Adrenal Hyperplasia

J Pediatr Adolesc Gynecol. 2017 Oct;30(5):520-534. doi: 10.1016/j.jpag.2017.04.001. Epub 2017 Apr 24.


The congenital adrenal hyperplasias comprise a family of autosomal recessive disorders that disrupt adrenal steroidogenesis. The most common form is due to 21-hydroxylase deficiency associated with mutations in the 21-hydroxylase gene, which is located at chromosome 6p21. The clinical features associated with each disorder of adrenal steroidogenesis represent a clinical spectrum that reflect the consequences of the specific mutations. Treatment goals include normal linear growth velocity and "on-time" puberty in affected children. For adolescent and adult women, treatment goals include regularization of menses, prevention of progression of hirsutism, and preservation of fertility. For adolescent and adult men, prevention and early treatment of testicular adrenal rest tumors is beneficial. In this article key aspects regarding pathophysiology, diagnosis, and treatment of congenital adrenal hyperplasia are reviewed.

Keywords: Ambiguous genitalia; CYP21A2; Congenital adrenal hyperplasia; Hyperandrogenism; Premature adrenarche; Premature pubarche.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Adrenal Hyperplasia, Congenital / diagnosis*
  • Adrenal Hyperplasia, Congenital / genetics
  • Adrenal Hyperplasia, Congenital / therapy
  • Adult
  • Child
  • Female
  • Fertility
  • Hirsutism
  • Humans
  • Male
  • Mutation
  • Sexual Maturation
  • Steroid 21-Hydroxylase / genetics*


  • CYP21A2 protein, human
  • Steroid 21-Hydroxylase