Ectopic Adrenal Rests in Congenital Adrenal Hyperplasia as a Cause of Androgen Excess After Adrenalectomy Detected by Pelvic Venous Sampling

January 2013 in “ Hormone Research in Paediatrics ”

Hedi L Claahsen-van der Grinten, Monica Stikkelbroeck, Johan Bulten, Michelle Heyer

congenital adrenal hyperplasia CAH androgen excess adrenalectomy secondary amenorrhea hair loss ovarian adrenal rests pelvic venous sampling unilateral oophorectomy

TLDR Ectopic adrenal rests can cause androgen excess after adrenalectomy and may need targeted surgery.

In a case study of a female patient with classic congenital adrenal hyperplasia (CAH) who underwent bilateral adrenalectomy in early puberty due to poorly controlled CAH, it was found that several years post-surgery, she developed secondary amenorrhea and hair loss. These symptoms were attributed to androgen overproduction from ovarian adrenal rests, which were detectable only through pelvic venous sampling. Following a unilateral oophorectomy, her androgen levels normalized, suggesting that ectopic adrenal rests can cause androgen excess even after adrenalectomy and may require targeted surgical intervention.

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