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May AMH levels distinguish LOCAH from PCOS among hirsute women?
[congenital adrenal hyperplasia]
To
determine
whether
women
with
polycystic
ovary
syndrome
(
PCOS
)
would
be
distinguishable
from
women
with
late
onset
congenital
adrenal
hyperplasia
(
LOCAH
)
on
the
basis
of
antimullerian
hormone
(
AMH
)
levels
.
PCOS
was
diagnosed
in
170
women
;
105
were
polycystic
ovary
morphology
(
PCOM
)
+
/
oligo-anovulation
(
OA
)
+
/
hyperandrogenism
(
HA
)
+
,
40
PCOM
+
/
OA-
/
HA
+
and
25
PCOM-
/
OA
+
/
HA
+
.
These
three
groups
were
compared
with
25
women
in
whom
LOCAH
was
diagnosed
.
The
mean
serum
AMH
levels
were
8
.
12
±
1
.
85
ng
/
ml
in
PCOM
+
/
OA
+
/
HA
+
group
,
5
.
34
±
1
.
82
ng
/
ml
in
PCOM
+
/
OA-
/
HA
+
group
,
3
.
02
±
1
.
76
ng
/
ml
in
PCOM-
/
OA
+
/
HA
+
group
and
4
.
43
±
1
.
29
ng
/
ml
in
LOCAH
group
.
The
mean
AMH
level
in
PCOM
+
/
OA
+
/
HA
+
group
was
approximately
twofold
higher
than
the
mean
AMH
level
measured
in
LOCAH
group
(
p
<
0
.
001
)
.
Women
with
PCOM
+
/
OA-
/
HA
+
had
higher
serum
AMH
levels
than
those
with
LOCAH
,
women
with
LOCAH
had
higher
serum
AMH
levels
than
those
with
PCOM-
/
OA
+
/
HA
+
but
these
differences
were
not
statistically
significant
(
p
>
0
.
05
)
.
AMH
is
not
suitable
for
distinguishing
LOCAH
from
all
types
of
hyperandrogenic
patterns
of
PCOS
,
but
is
only
applicable
for
a
specific
subtype
,
such
as
PCOS
patients
with
three
main
diagnostic
criteria
.
Therefore
,
ACTH
stimulation
test
remains
an
essential
clinical
tool
to
diagnose
LOCAH
.