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. 2019 Jul 1;7:263. doi: 10.3389/fped.2019.00263

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Copyright © 2019 Raina, Krishnappa, Das, Amin, Radhakrishnan, Nair and Kusumi.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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An overview of the steroid synthesis pathways and the enzyme deficiences that lead to congenital adrenal hyperplasia (CAH) types IV and V. The orange arrows show the activity of 11β-hydroxylase (deficient 1 in type IV) while the orange rectangle surrounds the steroid hormones still produced in CAH type IV. The green arrows denote the activity of 17α-hydroxylase (deficient in type V) while the green rectangle encircles those hormones produced in CAH type V. ACTH - adrenocorticotropic hormone; DHEA - dihydroepiandrosterone. ^*These metabolites are active at the mineralocorticoid receptor and are important in generating hypertension.