Malignant Hypertension in Congenital Adrenal Hyperplasia with 21- Hydroxylase Deficiency: A Case Report

Congenital adrenal hyperplasia (CAH) should be considered in patients presenting with hypertension. CAH is mainly associated with deficiencies in 11β, 17α, and 21-hydroxylases. While deficiencies in 11β and 17α-hydroxylases are known to induce secondary hypertension, the association with 21-hydroxylase deficiency (21-OHD) is extremely rare. We present a case of a 60-year-old woman with an episode of seizures due to malignant hypertension. She was diagnosed with nonclassic CAH induced by 21-OHD, leading to malignant hypertension. Through treatment with both antihypertensive medications and hydrocortisone supplements, her blood pressure and laboratory results improved significantly. In conclusion, it is important to consider 21-OHDinduced nonclassic CAH as a possible genetic cause of secondary hypertension.