Late-Onset Adrenal Hyperplasia

To the Editor: The excellent article by Kuttenn on late-onset adrenal hyperplasia in hirsute women (July 25 issue) 1 describes 24 cases of partial 21-hydroxylase deficiency among 400 subjects — probably too small a number to justify similar investigation in routine clinical practice. The HLA associations and the variability in clinical expression of the defect are also notable and elegantly explicated. When we described a variant of this disorder due to a deficiency of 3-beta-hydroxysteroid dehydrogenase 2 we considered it rare — an opinion that has often been expressed by others but that is no longer tenable. In a study of a . . . No extract is available for articles shorter than 400 words.