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Cell injury and cellular adaptive changes

Disorders of Adrenal cortical function 6.7.1 Congenital adrenal hyperplasia (adrenogenital syndrome) Congenital adrenal hyperplasia (CAH) describes a congenial disorder caused by an autosomal recessive trait in which a deficiency exists in any of the five enzymes. It is a defect in the synthesis of cortex that results in increased levels of ACTH and adrenal hyperplasia. The increased levels of ACTH over stimulate the pathways of steroid hormone production, particularly those involving the production of adrenal androgens. Mineralocorticoids may be produced in excessive or insufficient amount, depending on the precise enzyme deficiency. Both males and females are affected. Males are seldom diagnosed at birth, unless they have enlarged genitalia or lose salt and manifest adrenal crisis; in female infants, an increase in androgens is responsible for creating the virilization syndrome of ambiguous genitalia.