What is a cause of congenital adrenal hyperplasia?

Congenital adrenal hyperplasia (CAH) primarily results from a deficiency in enzymes involved in steroid hormone synthesis within the adrenal glands. The most common form of CAH is due to a deficiency in 21-hydroxylase, which is essential for the production of cortisol and aldosterone. When 21-hydroxylase is deficient, this can lead to an accumulation of steroid precursors and a subsequent decrease in adrenal corticoids, which can disrupt normal physiological balance and lead to an excess production of androgens.

In the context of the options provided, the correct answer focuses on the enzymes that have a critical impact on adrenal steroidogenesis. The deficiency of 21 beta-hydroxylase leads to the characteristic symptoms of CAH, including ambiguous genitalia in females and precocious puberty in males, as a result of increased adrenal androgens. The other options pertain to different enzyme deficiencies which may lead to other conditions but do not represent the most common form of congenital adrenal hyperplasia.

21 alpha-hydroxylase deficiency, while it is a recognized variant of CAH, is less commonly referred to than its beta counterpart in certain contexts. Deficiencies of 11 beta-hydroxylase and