In males, the non-classic form of 21-hydroxylase deficiency, also known as late-onset or mild congenital adrenal hyperplasia (CAH), typically presents with milder and subtler symptoms compared to the classic form. Here are some common features of how it may present:
1. Symptoms in Adolescence or Adulthood: Unlike the classic form, which often presents in infancy or early childhood, non-classic CAH symptoms may not appear until adolescence or adulthood.
2. Androgen Excess: The main clinical feature is an excess of androgen hormones, such as testosterone. This can lead to symptoms like:
• Excessive hair growth (hirsutism): Affected males may develop increased facial and body hair.
• Acne: Skin problems, including acne, can be more common.
• Voice Changes: Some individuals may experience a deeper voice.
• Irregular Menstrual Cycles: In females with non-classic CAH, irregular menstrual cycles and fertility issues can occur.
3. Less Severe Salt Wasting: Unlike the classic form, which can have life-threatening salt-wasting crises in infancy, non-classic CAH typically does not involve severe salt-wasting.
4. Variable Severity: The symptoms and their severity can vary among individuals with non-classic CAH. Some may have very mild or almost no symptoms, while others may experience more pronounced androgen-related issues.