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Iatreia
Print version ISSN 0121-0793
Abstract
RUIZ-RIVERA, Maria Camila and MENDOZA-ROJAS, Víctor Clemente. Management with five antihypertensives in patient with precocious puberty. Case report. Iatreia [online]. 2018, vol.31, n.3, pp.305-311. ISSN 0121-0793. https://doi.org/10.17533/udea.iatreia.v31n3a09.
Introduction:
Congenital adrenal hyperplasia due to 11 beta-hydroxylase deficiency is an infrequent autosomal recessive disease and the associated cardiovascular complications in the advanced stages make the management even more complex.
Case presentation:
A male patient who starts pubarche at 2 years old, therefore, he is diagnosed with congenital adrenal hyperplasia due to 11 beta-hydroxylase deficiency, and subsequent hypertension from age 5. At eight-years-old, he is hospitalized for a foodborne illness that causes adrenal insufficiency. Additionally, he is diagnosed with peripheral precocious puberty, melanoderma, hypokalemia and left ventricular hypertrophy. He required stress dose of hydrocortisone and five antihypertensives.
Discussion:
Treatment determines a patient’s prognosis. Therefore, once precocious puberty and hypertension produce irreversible complications such as deterioration of the final height and left ventricular hypertrophy respectively, the management is extremely difficult.
Keywords : Adrenal Hyperplasia, Congenital; Adrenal Insufficiency; Hypertension; Precocious Puberty; Steroid 11 beta-Hydroxylase.