Diferenciação sexual anormal ou distúrbios congênitos do desenvolvimento sexual causados por níveis anormais de hormônios esteróides expressos pelas gônadas ou pelas glândulas supra-renais, como na hiperplasia adrenal congênita e nas neoplasias do córtex adrenal. Devido à biossíntese anormal de esteróides, as características clínicas incluem virilismo em mulheres; feminização em homens; ou desenvolvimento sexual precoce em crianças.
Introdução
O que você precisa saber de cara
A síndrome adrenogenital é uma condição rara em que as glândulas suprarrenais ou gônadas produzem quantidades inadequadas de hormônios esteroides. Isso pode provocar alterações na formação da genitália externa, puberdade precoce em crianças ou virilização em mulheres. O acompanhamento envolve a dosagem constante desses hormônios e avaliação genética dos genes responsáveis, como o CYP21A2. No SUS, o cipionato de hidrocortisona foi mantido por decisão da CONITEC, mas a condição ainda não possui um protocolo com lista de dispensação direta regularizada.
Diferenciação sexual anormal ou distúrbios congênitos do desenvolvimento sexual causados por níveis anormais de hormônios esteróides expressos pelas gônadas ou pelas glândulas supra-renais, como na hiperplasia adrenal congênita e nas neoplasias do córtex adrenal. Devido à biossíntese anormal de esteróides, as características clínicas incluem virilismo em mulheres; feminização em homens; ou desenvolvimento sexual precoce em crianças.
O que está sendo pesquisado
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Entender a doença
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Sinais e sintomas
O que aparece no corpo e com que frequência cada sintoma acontece
Partes do corpo afetadas
+ 139 sintomas em outras categorias
Características mais comuns
Os sintomas variam de pessoa para pessoa. Abaixo estão as 235 características clínicas mais associadas, ordenadas por frequência.
Linha do tempo da pesquisa
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Genética e causas
O que está alterado no DNA e como passa nas famílias
Genes associados
9 genes identificados com associação a esta condição.
Adrenal hyperplasia 3
A form of congenital adrenal hyperplasia, a common recessive disease due to defective synthesis of cortisol. Congenital adrenal hyperplasia is characterized by androgen excess leading to ambiguous genitalia in affected females, rapid somatic growth during childhood in both sexes with premature closure of the epiphyses and short adult stature. Four clinical types: 'salt wasting' (SW, the most severe type), 'simple virilizing' (SV, less severely affected patients), with normal aldosterone biosynthesis, 'non-classic form' or late-onset (NC or LOAH) and 'cryptic' (asymptomatic).
Diarrhea 6
A relatively mild, early-onset chronic diarrhea that may be associated with increased susceptibility to inflammatory bowel disease, small bowel obstruction, and esophagitis.
Adrenal hyperplasia 4
A form of congenital adrenal hyperplasia, a common recessive disease due to defective synthesis of cortisol. Congenital adrenal hyperplasia is characterized by androgen excess leading to ambiguous genitalia in affected females, rapid somatic growth during childhood in both sexes with premature closure of the epiphyses and short adult stature. Four clinical types: 'salt wasting' (SW, the most severe type), 'simple virilizing' (SV, less severely affected patients), with normal aldosterone biosynthesis, 'non-classic form' or late-onset (NC or LOAH) and 'cryptic' (asymptomatic).
Adrenal hyperplasia 2
A form of congenital adrenal hyperplasia, a common recessive disease due to defective synthesis of cortisol. Congenital adrenal hyperplasia is characterized by androgen excess leading to ambiguous genitalia in affected females, rapid somatic growth during childhood in both sexes with premature closure of the epiphyses and short adult stature. Four clinical types: 'salt wasting' (SW, the most severe type), 'simple virilizing' (SV, less severely affected patients), with normal aldosterone biosynthesis, 'non-classic form' or late-onset (NC or LOAH) and 'cryptic' (asymptomatic). In AH2, virilization is much less marked or does not occur. AH2 is frequently lethal in early life.
Cortisone reductase deficiency 2
An autosomal dominant error of cortisone metabolism characterized by a failure to regenerate cortisol from cortisone, resulting in increased cortisol clearance, activation of the hypothalamic- pituitary axis and ACTH-mediated adrenal androgen excess. Clinical features include hyperandrogenism resulting in hirsutism, oligo- amenorrhea, and infertility in females and premature pseudopuberty in males.
Cortisone reductase deficiency 1
An autosomal recessive error of cortisone metabolism characterized by a failure to regenerate cortisol from cortisone, resulting in increased cortisol clearance, activation of the hypothalamic-pituitary axis and ACTH-mediated adrenal androgen excess. Clinical features include hyperandrogenism resulting in hirsutism, oligo-amenorrhea, and infertility in females and premature pseudopuberty in males.
Adrenal hyperplasia 5
A form of congenital adrenal hyperplasia, a common recessive disease due to defective synthesis of cortisol. Congenital adrenal hyperplasia is characterized by androgen excess leading to ambiguous genitalia in affected females, rapid somatic growth during childhood in both sexes with premature closure of the epiphyses and short adult stature. Four clinical types: 'salt wasting' (SW, the most severe type), 'simple virilizing' (SV, less severely affected patients), with normal aldosterone biosynthesis, 'non-classic form' or late-onset (NC or LOAH) and 'cryptic' (asymptomatic).
Antley-Bixler syndrome, with genital anomalies and disordered steroidogenesis
A disease characterized by the association of Antley-Bixler syndrome with steroidogenesis defects and abnormal genitalia. Antley-Bixler syndrome is characterized by craniosynostosis, radiohumeral synostosis present from the perinatal period, midface hypoplasia, choanal stenosis or atresia, femoral bowing and multiple joint contractures.
Glucocorticoid resistance, generalized
An autosomal dominant disease characterized by increased plasma cortisol concentration and high urinary free cortisol, resistance to adrenal suppression by dexamethasone, and the absence of Cushing syndrome typical signs. Clinical features include hypoglycemia, hypertension, metabolic alkalosis, chronic fatigue and profound anxiety.
Medicamentos e terapias
Mecanismo: Glucocorticoid receptor agonist
Mecanismo: Glucocorticoid receptor agonist
Mecanismo: Glucocorticoid receptor agonist
Mecanismo: Glucocorticoid receptor agonist
Mecanismo: Glucocorticoid receptor agonist
Mecanismo: Glucocorticoid receptor agonist
Mecanismo: Mineralocorticoid receptor agonist
Mecanismo: Corticotropin releasing factor receptor 1 antagonist
Mecanismo: Acyl coenzyme A:cholesterol acyltransferase 1 inhibitor
Mecanismo: Cytochrome P450 17A1 inhibitor
Variantes genéticas (ClinVar)
686 variantes patogênicas registradas no ClinVar.
Vias biológicas (Reactome)
20 vias biológicas associadas aos genes desta condição.
Diagnóstico
Os sinais que médicos procuram e os exames que confirmam
Tratamento e manejo
Remédios, cuidados de apoio e o que precisa acompanhar
Onde tratar no SUS
Hospitais de referência no Brasil e o protocolo oficial do SUS (PCDT)
🇧🇷 Atendimento SUS — Síndrome adrenogenital
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Pesquisa ativa
Ensaios clínicos abertos e novidades científicas recentes
Ensaios em destaque
Nenhum país com ensaio aberto no momento.
Pesquisa e ensaios clínicos
2 ensaios clínicos encontrados.
Publicações mais relevantes
Long-term outcomes in patients with congenital adrenal hyperplasia treated with hydrocortisone modified-release hard capsules.
Hydrocortisone modified-release hard capsules (MRHC, development name Chronocort) replace the physiological overnight cortisol rise and improve the biochemical control of congenital adrenal hyperplasia (CAH). This study aims to evaluate long-term safety, tolerability, and efficacy of MRHC. This is an open-label follow-on study. Ninety-one patients with classic CAH, mean age 37 years, 68% female, 32% male, entered the study and 22 discontinued. Median treatment duration was 4 years (range 0.2-5.8). Median hydrocortisone dose at study entry was 30 mg/day and reduced to 20 mg/day after 24 weeks and stayed stable thereafter until 48 months (P < .0001). Disease control improved on MRHC for the steroid disease markers serum 17-hydroxyprogesterone (17OHP) (P < .03) and androstenedione (A4) (P < .002). After 4 years, the majority of patients had a 17OHP < 4-fold upper limit of normal (ULN) (71%) and an A4 <ULN (90%). Measurement of 17OHP and A4 at 09:00 h and 13:00 h gave similar results. Of the 37 women < 50 years of age who were not on contraceptives over the whole study period, 5 became pregnant (13.5%). Of the men, 13.8% (4/29) had a partner pregnancy. Seven patients had an adrenal crisis with 1 patient reporting 8 of these giving an incidence of 3.9 crises per 100 patient years. Modified-release hard capsule treatment resulted in hydrocortisone dose reduction followed by a stable dose with improved biochemical control associated with fertility. Biochemical control could be reliably monitored by a single blood sample taken between 09:00 and 13:00 h. The incidence of adrenal crises was below that reported previously in patients with CAH.
46, XX DSD with Atypical Genitalia: Clinical Insights and Diagnostic Approaches.
Congenital adrenal hyperplasia (CAH) is a rare disorder with autosomal recessive inheritance; it was historically known as adrenogenital syndrome. Patients with virilizing forms of CAH and a 46,XX karyotype present with varied degrees of hyperandrogenism due to different genetic defects in the adrenal steroidogenesis pathway. This comprehensive review describes a simplified diagnostic approach for patients with atypical genitalia and 46, XX DSD. It highlights the importance of a detailed history and clinical examination, with specific pointers toward the etiological diagnosis. There is a need for utilizing standardized liquid chromatography/tandem mass spectrometry (LC-MS/MS) assays to accurately diagnose these disorders of steroidogenesis. Choosing appropriate molecular testing methods has significant implications for establishing the diagnosis and providing genetic counseling.
Bilateral testicular mass in a 21-year-old male with a history of congenital adrenal hyperplasia: A case report.
A 21-year-old man was referred because of bilateral testicular swelling from 8 months ago. He had a known history of congenital adrenal hyperplasia (21-hydroxylase deficiency) diagnosed in infancy, managed with glucocorticoid therapy since childhood. However, the patient had been non-adherent to medication for several years. The patient underwent surgery with an inguinal incision, and a biopsy from the mass was sent for frozen section. The frozen and permanent sections were consistent with "Testicular adrenal rest tumor (tumor of adrenogenital syndrome).
[Not Available].
Congenital adrenal hyperplasia (CAH) arises from genetic enzyme defects, often in CYP21A2, causing primary adrenal insufficiency. In this case report, a man in his late 20s with lifelong CAH faced challenges in adhering to medication. Suboptimal treatment led to the development of testicular adrenal rest tumours, diagnosed by ultrasound, and hypogonadism. Enhanced adherence restored hormone levels, promoting eugonadism. Adherence plays a crucial role in diminishing tumour size and preventing complications, potentially necessitating orchiectomy in severe cases.
[Testicular adrenal rest tumors (TARTs) and adrenogenital syndrome (AGS) - Do not mix up with malignant testicular tumors!].
Testicular adrenal rest tumors and adrenogenital syndrome (AGS) - Do not mix up with malignant testicular tumors! Testicular adrenal residual tumors (TARTs) frequently occur in men with adrenogenital syndrome. Without knowledge of AGS, diagnosis is problematic due to difficult differentiation from other testicular tumors. However, early treatment is crucial for maintaining or regaining fertility, among other aspects. This article provides background knowledge for general practitioners.
Publicações recentes
Long-term outcomes in patients with congenital adrenal hyperplasia treated with hydrocortisone modified-release hard capsules.
46, XX DSD with Atypical Genitalia: Clinical Insights and Diagnostic Approaches.
Bilateral testicular mass in a 21-year-old male with a history of congenital adrenal hyperplasia: A case report.
[Testicular adrenal rest tumors (TARTs) and adrenogenital syndrome (AGS) - Do not mix up with malignant testicular tumors!].
[The androgenital syndrome: Don't just think about it in childhood!].
📚 EuropePMC679 artigos no totalmostrando 28
Long-term outcomes in patients with congenital adrenal hyperplasia treated with hydrocortisone modified-release hard capsules.
European journal of endocrinology46, XX DSD with Atypical Genitalia: Clinical Insights and Diagnostic Approaches.
Hormone and metabolic research = Hormon- und Stoffwechselforschung = Hormones et metabolismeBilateral testicular mass in a 21-year-old male with a history of congenital adrenal hyperplasia: A case report.
Urology case reports[Testicular adrenal rest tumors (TARTs) and adrenogenital syndrome (AGS) - Do not mix up with malignant testicular tumors!].
MMW Fortschritte der Medizin[The androgenital syndrome: Don't just think about it in childhood!].
MMW Fortschritte der MedizinCongenital adrenal hyperplasia. Role of dentist in early diagnosis.
Open medicine (Warsaw, Poland)Taking "Trans-ano-rectal" out of ASTRA: An anterior sagittal approach without splitting the rectum.
Journal of pediatric urologyAtypical Presentation of Testicular Adrenal Rest Tumor (TART) Leading to Bilateral Partial Orchiectomy in a 31-Year-Old Adult Revealing Primary Adrenal Insufficiency with CYP11A1 Deficiency.
Case reports in endocrinologyTransitional cell metaplasia of the uterine cervix: A histopathological and immunohistochemical analysis suggesting a possible role of androgenic conversion during urothelial-like differentiation in peri/postmenopausal women.
Annals of diagnostic pathologyNovel SCNN1A gene splicing-site mutation causing autosomal recessive pseudohypoaldosteronism type 1 (PHA1) in two Italian patients belonging to the same small town.
Italian journal of pediatricsIncidental Finding of Bilateral Ovarian Adrenal Rest Tumor in a Patient With Congenital Adrenal Hyperplasia: A Case Report and Brief Review.
Pediatric and developmental pathology : the official journal of the Society for Pediatric Pathology and the Paediatric Pathology SocietyDisorders of Sex Development: Classification, Review, and Impact on Fertility.
Journal of clinical medicineCOMPLEX ORPHAN PATHOLOGY: COMORBIDITY OF MUCOVISCIDOSIS AND CONGENITAL DYSFUNCTION OF ADRENAL GLANDS CORTEX (REFERENCES REVIEW AND OWN RESEARCH).
Wiadomosci lekarskie (Warsaw, Poland : 1960)[Hyperandrogenism, adrenal dysfunction, and hirsutism].
Der Hautarzt; Zeitschrift fur Dermatologie, Venerologie, und verwandte GebieteCongenital adrenal hyperplasia: Does repair after two years of age have a worse outcome?
Journal of pediatric urologyExome-based search for recurrent disease-causing alleles in Russian population.
European journal of medical geneticsGenitoplasty in newborn females with adrenogenital syndrome: Focus on the reconstruction technique and its outcomes.
Journal of pediatric urologyA rare case of hydrometrocolpos from persistent urogenital sinus in patient affected by adrenogenital syndrome.
Journal of ultrasoundGiant Cavernous Hemangioma of the Adrenal Gland in an Elderly Patient.
Internal medicine (Tokyo, Japan)Testicular tumors of adrenogenital syndrome: From physiopathology to therapy.
Presse medicale (Paris, France : 1983)Reduced steroidogenesis in patients with PCDH19-female limited epilepsy.
EpilepsiaImmunophenotypic differences between neoplastic and non-neoplastic androgen-producing cells containing and lacking Reinke crystals.
Virchows Archiv : an international journal of pathologyShould CAH in Females Be Classified as DSD?
Frontiers in pediatricsIdiopathic female pseudohermaphroditism with urethral duplication and female hypospadias.
BMJ case reportsLeydig cell tumour and giant adrenal myelolipoma associated with adrenogenital syndrome: a case report with a review of the literature.
UrologiaBilateral Idiopathic Adrenal Hyperplasia: Genetics and Beyond.
Hormone and metabolic research = Hormon- und Stoffwechselforschung = Hormones et metabolismeMetachronous Bilateral Testicular Leydig-Like Tumors Leading to the Diagnosis of Congenital Adrenal Hyperplasia (Adrenogenital Syndrome).
Case reports in pathologyGender Dysphoria in 46,XX Persons with Adrenogenital Syndrome Raised as Females: An Addendum.
Frontiers in pediatricsAssociações
Organizações que acompanham esta doença — pra ter apoio e orientação
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Doença com base genética
Um médico geneticista pode ajudar no diagnóstico de Síndrome adrenogenital e no aconselhamento genético da família.
Doenças relacionadas
Doenças com sintomas parecidos — ajudam quem ainda está buscando diagnóstico
Perguntas frequentes
O que as famílias mais perguntam sobre esta doença — cada resposta com a fonte de onde saiu
A síndrome é provocada por alterações na síntese de esteroides nas suprarrenais ou gônadas, frequentemente ligadas a mutações em genes como CYP21A2 e CYP11B1. Essas mutações comprometem enzimas necessárias para a regulação dos hormônios no corpo.
Referências
Fontes citadas no texto, publicações do grafo e bases de dados usadas neste verbete
6 publicações do grafo RarasNet (PubMed) · 6 bases de dados. Títulos, periódicos e PMIDs vêm direto da fonte, sem intermediação de IA.
Dados compilados pelo RarasNet a partir de fontes abertas (Orphanet, OMIM, MONDO, PubMed/EuropePMC, ClinicalTrials.gov, DATASUS, PCDT/MS). Este conteúdo é informativo e não substitui avaliação médica.
Citar este verbete
Raras. (s.d.). Síndrome adrenogenital. Em Raras — Enciclopédia de Doenças Raras do Brasil. https://raras.org/doenca/sindrome-adrenogenital
Formato APA. Conteúdo sob CC BY 4.0 — reuso livre com atribuição.
Conteúdo mantido por Agente Raras · Médicos e pesquisadores podem colaborar
Síndrome adrenogenital
📋 Origem dos dados
Esta página agrega dados de fontes públicas e oficiais. Dados sobre cobertura no SUS (PCDT, CEAF) são verificados ativamente por agente proativo (ver badge no infobox). Demais dados têm atribuição de fonte + data da última sincronização — clique para abrir o original.
- Doença rara (ontologia)
- fonte: Orphanet
- Identificador unificado
- fonte: MONDO
- Codificação WHO/SUS
- fonte: WHO ICD-10 / DATASUS
- CID-11 (futuro)
- fonte: WHO ICD-11
- NIH/GARD
- fonte: GARD (NIH)
- Indexação biomédica
- fonte: MeSH (NLM)
- Dado público estruturado
- fonte: Wikidata
- Moléculas estudadas na doença
- fonte: OpenTargets
- Reposicionamento
- fonte: Drug Repurposing Hub