Non-classical Adrenal Hyperplasia
Non-classical(NCAH) (also known as Late-Onset CAH) is a variation of CAH that can begin to cause noticeable changes at any time from early childhood through early adulthood but is not immediately life-threatening. NCAH can have a range of symptoms which overlap with other disorders and therefore may not be easily diagnosed, and so is less likely to be diagnosed promptly.
Girls born with NCAH have normal genitals. Boys also appear normal. Because the symptoms begin later in life, NCAH is sometimes called late-onset CAH, adult-onset CAH, or the attenuated form of CAH. Non-classical CAH does not progress to classical CAH in affected individuals.
NCAH may be picked up in infants through newborn screening tests, but they do not necessarily need treatment. Parents can be aware of the symptoms of the disorder and seek treatment if it becomes necessary. Only those children/adults who are symptomatic should be treated. Some with NCAH never experience bothersome symptoms. Those with NCAH who have no symptoms do not need treatment.
What are the symptoms of NCAH?
NCAH symptoms vary from person to person. Also, one person’s symptoms may come and go over time. These symptoms can begin at any time in life and may start in early childhood. These symptoms are often mistaken for premature puberty - girls with signs of puberty before age 8 and boys before age 9. It is progressive, meaning that the untreated symptoms may become worse over time.
Both males and females with NCAH may show the following:
Premature development of body hair (pubic and underarm)
Body odor (young children’s perspiration normally has no odor)
Early, rapid growth spurt, but ultimately short stature as adult
Oily hair and skin
Severe acne
Mood swings
Infertility
In females, symptoms most frequently become apparent shortly after the onset of menstruation and may include the following (as well as those symptoms mentioned above):
Early age of first menstrual period
Menstrual irregularities
Thinning hair on head, especially at the temples (male pattern baldness)
Excessive hair growth; facial hair on chin and upper lip may be thick, coarse, and dark
Previous diagnosis or symptoms of Polycystic Ovarian Syndrome (PCOS).