CAH majority due to deficiency of which enzyme?

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Multiple Choice

CAH majority due to deficiency of which enzyme?

Explanation:
The main concept is that most cases of congenital adrenal hyperplasia are due to a deficiency of 21-hydroxylase, the enzyme that converts 17-hydroxyprogesterone to the next step in both cortisol and aldosterone synthesis. When 21-hydroxylase is deficient, cortisol and aldosterone production drop, ACTH rises, the adrenal glands enlarge, and androgens rise, leading to virilization and potential salt-wasting crises. The buildup of 17-hydroxyprogesterone is a hallmark that helps identify this form. Other enzyme defects, like 11β-hydroxylase deficiency, are rarer and usually cause hypertension; ACTH deficiency is a different adrenal problem overall, not CAH; and deficiency of 17-hydroxyprogesterone isn’t a known cause of CAH (the problem is its accumulation, not a deficiency).

The main concept is that most cases of congenital adrenal hyperplasia are due to a deficiency of 21-hydroxylase, the enzyme that converts 17-hydroxyprogesterone to the next step in both cortisol and aldosterone synthesis. When 21-hydroxylase is deficient, cortisol and aldosterone production drop, ACTH rises, the adrenal glands enlarge, and androgens rise, leading to virilization and potential salt-wasting crises. The buildup of 17-hydroxyprogesterone is a hallmark that helps identify this form. Other enzyme defects, like 11β-hydroxylase deficiency, are rarer and usually cause hypertension; ACTH deficiency is a different adrenal problem overall, not CAH; and deficiency of 17-hydroxyprogesterone isn’t a known cause of CAH (the problem is its accumulation, not a deficiency).

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