The full content of Annals is available to subscribers

Subscribe/Learn More  >
Brief Communications |

Management of Virilizing Congenital Adrenal Hyperplasia with Cyproheptadine

[+] Article, Author, and Disclosure Information

▸Requests for reprints should be addressed to Tah-Hsiung Hsu, M.D.; Department of Medicine, The John Hopkins Hospital, 601 North Broadway; Baltimore, MD 21205.

Baltimore, Maryland

Ann Intern Med. 1980;92(5):628-630. doi:10.7326/0003-4819-92-5-628
Text Size: A A A

Hyperandrogenism secondary to hypersecretion of ACTH in patients with congenital adrenal hyperplasia is frequently a problem in therapeutic management. Despite the use of steroids and antiandrogens, virilism often persists. This paper reports the beneficial effects of cyproheptadine in two adult patients with C-21 hydroxylase deficiency who had persistently increased secretion of androgens while on supraphysiologic doses of prednisone. When cyproheptadine was administered in addition to steroids, plasma androgen levels, ACTH, and urinary 17-ketosteroid and pregnanetriol excretion rates returned to normal and clinical improvement was observed. Discontinuation of cyproheptadine therapy in one patient resulted in prompt recurrence of hyperandrogenemia, which was again ameliorated with reinstitution of the drug. From these findings, I conclude that while glucocorticoids are the mainstay of management of virilizing congenital adrenal hyperplasia, cyproheptadine may be an effective adjunct in some patients with this disorder.





Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).


Submit a Comment/Letter
Submit a Comment/Letter

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.


Buy Now for $42.00

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Related Articles
Topic Collections
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.