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[Rare forms of female pseudohermaphroditism: when to investigate?].
[aromatase deficiency]
The
congenital
adrenal
hyperplasia
is
the
commonest
cause
of
ambiguity
of
the
external
genitalia
at
birth
,
due
to
classic
forms
of
21
-
hydroxylase
and
11
beta
-hydroxylase
deficiencies
.
3
beta
-hydroxysteroid
dehydrogenase
(
3
betaHSD
)
is
a
rare
disorder
that
affects
both
sexes
and
female
patients
may
have
ambiguous
genitalia
.
Familial
glucocorticoid
resistance
is
characterized
by
increased
cortisol
secretion
without
clinical
evidence
of
hypercortisolism
,
but
with
manifestations
of
androgen
and
mineralocorticoid
excess
,
caused
by
glucocorticoid
receptor
gene
mutation
,
and
rarely
can
lead
to
female
pseudohermaphroditism
.
Placental
aromatase
deficiency
is
a
rare
disease
characterized
by
a
masculinized
female
fetus
and
a
virilized
mother
,
which
should
be
considered
in
the
absence
of
fetal
adrenal
hyperplasia
and
maternal
androgen-secreting
tumours
.
Finally
,
mutations
of
P
450
oxidoreductase
causes
disordered
steroidogenesis
with
ambiguous
genitalia
.
The
investigation
of
abnormal
sexual
development
requires
an
initial
karyotype
analysis
and
serum
17
OH
progesterone
,
11
deoxycortisol
,
17
pregnenolone
,
and
androgen
measurements
to
assess
the
diagnosis
of
different
forms
of
congenital
adrenal
hyperplasia
.
Diseases
Validation
Diseases presenting
"abnormal sexual development"
symptom
aromatase deficiency
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