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Start free with EleplanClassic congenital adrenal hyperplasia due to 21-hydroxylase deficiency
ORPHA:90794Disease
Also called Classic 21-OHD CAH
What it is
A form of congenital adrenal hyperplasia (CAH) characterized by simple virilizing or salt wasting forms that can manifest with abnormal genital development with variable levels of virilization in females and with adrenal insufficiency in both sexes, and that presents with dehydration and hypoglycemia (which can be lethal if left untreated) in the neonatal period, as well as hyperandrogenemia.
Key facts
- Prevalence
- 1-9 / 100 000 (Europe)
- Age of onset
- Adolescent, Adult, Antenatal, Childhood, Infancy, Neonatal
- Inheritance
- Autosomal recessive
- Classified as
- Disease
Prevalence figures describe populations, not individuals, and are often estimates from a single study. Where the figure is an incidence or a birth prevalence, it says so.
Signs and symptoms
Very common80–99%
5Common30–79%
36- Abnormal external genitalia
- Abnormality of the menstrual cycle
- Abnormal ovarian physiology
- Abnormal serum dehydroepiandrosterone level
- Accelerated skeletal maturation
- Acne
- Clitoral hypertrophy
- Decreased circulating aldosterone level
- Decreased fertility
- Dehydration
- Elevated urinary epinephrine
- Failure to thrive
- Feeding difficulties
- Growth abnormality
- Hirsutism
- Hyperactive renin-angiotensin system
- Hyperkalemia
- Hyperkalemic metabolic acidosis
- Hypernatriuria
- Hypocapnia
- Hypochloremia
- Hyponatremia
- Hypotension
- Hypovolemia
- Increased circulating ACTH level
- Increased circulating androstenedione concentration
- Increased serum testosterone level
- Neonatal hypoglycemia
- Oligomenorrhea
- Premature fusion of the radial epiphyseal plates
- Premature pubarche
- Primary adrenal insufficiency
- Renal salt wasting
- Short stature
- Vomiting
- Weight loss
These ranges are how often a sign appears across everyone diagnosed, not a prediction for one person — most people have some of these and not others. Orphanet also records findings that are specifically absent in this disease; those are in the data but not listed here.
Genes reported in subtypes
Orphanet records this gene on 2 more specific entries under this disorder, not on this entry itself:
A well-studied disease is usually split into subtypes, and the gene is curated on whichever one the evidence belongs to. Open a subtype to see which gene goes with it.
ICD-10 codes
ICD-10 has no distinct code for most rare diseases, so many are filed under the nearest available one. A shared code identifies the group, not this disease — the ORPHAcode above is what identifies it.
Cross-references
Orphadata Science: Free access data from Orphanet. © INSERM 1999. Data version 2026-06-23. Available under CC BY 4.0. This is a reference, not medical advice.
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