The incidence of classic 21-hydroxylase deficiency varies by population and ranges from 1 case per 5000-15,000 live births to as high as 1 case per 300-700 births in Alaskan Yupik Eskimos. The next most common type of CAH, 11-beta-hydroxylase deficiency, has an incidence of about 1 in 100,000 persons. Less than 5% of all patients worldwide with CAH have 3-beta–hydroxysteroid dehydrogenase deficiency. In one study of 81 children with ambiguous genitalia, only 2 were found to have 3-beta–hydroxysteroid dehydrogenase deficiency. [10] The incidence is higher in some populations; 3-beta–hydroxysteroid dehydrogenase deficiency is relatively common in the Old Order Amish in North America associated with a HSD3B2 c.35G, a founder mutation. [11] Patients with complete 3-beta–hydroxysteroid dehydrogenase deficiency are at risk for acute adrenal insufficiency when ill. Patients and their families should be instructed in the use of stress doses of glucocorticoids for acute illness (eg, temperature ≥101°F) or major trauma. If medication can be taken orally, the patient should double or triple the usual dose of glucocorticoid for 3 days.
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Mapa do Reino Unido. Os quatro países que formam o Reino Unido aparecem nas seguinte cores: a Inglaterra em marrom claro, o País de Gales, em rosa, a Escócia, em verde, e a Irlanda do Norte, em roxo claro. Países do Reino Unido. Cada um possui um parlamento próprio, bandeira e chefe de governo. No entanto, não podem emitir moeda, nem possuir exército e emitir passaportes. Além disso, o chefe de Estado, é o chefe da da Casa de Windsor. Reino Unido. Ire apk.
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