CYP21A2 Genotypes Do Not Predict the Severity of Hyperandrogenic Manifestations in the Nonclassical Form of Congenital Adrenal Hyperplasia

The study involving 114 patients with nonclassical congenital adrenal hyperplasia (NC-CAH) found that CYP21A2 genotypes, categorized as mild or severe, did not predict the severity of hyperandrogenic manifestations such as hirsutism, menstrual abnormalities, or basal testosterone levels. Despite higher basal and ACTH-stimulated 170HP levels in patients with severe genotypes, there was significant overlap between the two genotype groups, and no significant differences in clinical manifestations were observed. The study concluded that the variability in hyperandrogenism in NC-CAH is not dependent on the CYP21A2 genotype severity, suggesting that other genetic factors might influence the clinical features. This conclusion was reinforced by the different clinical presentations observed in siblings with identical genotypes.