{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T01:01:42Z","timestamp":1773018102088,"version":"3.50.1"},"reference-count":10,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,2,22]],"date-time":"2026-02-22T00:00:00Z","timestamp":1771718400000},"content-version":"vor","delay-in-days":21,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Obstet and Gynaecol"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    We report a rare case of nonclassical 21\u2010hydroxylase deficiency (NC21\u2010OHD) diagnosed in adulthood after being misdiagnosed as polycystic ovary syndrome (PCOS) for 9\u2009years. A 27\u2010year\u2010old Japanese woman presented with longstanding amenorrhea, hirsutism, and polycystic ovarian morphology on ultrasonography but did not exhibit withdrawal bleeding after standard estrogen\/progestin (E\/P) therapy. Hormonal evaluation revealed a low luteinizing hormone (LH) level, elevated testosterone (T), and a significantly increased 17\u03b1\u2010hydroxyprogesterone level, which further increased following adrenocorticotropic hormone stimulation. Genetic analysis identified compound heterozygous mutations in the\n                    <jats:italic>CYP21A2<\/jats:italic>\n                    gene (c.92C&gt;T; c.293\u201013C&gt;G), confirming the diagnosis of NC21\u2010OHD. This case underscores the importance of considering NC21\u2010OHD in adolescents and young adults with atypical PCOS features, such as severe hirsutism, abnormal hormonal profiles (low LH with markedly elevated T levels), and resistance to standard E\/P therapy.\n                  <\/jats:p>","DOI":"10.1111\/jog.70191","type":"journal-article","created":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T01:54:47Z","timestamp":1771811687000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Decade\u2010Long Diagnostic Challenge: A Case of Nonclassical 21\u2010Hydroxylase Deficiency Mistaken for Polycystic Ovary Syndrome"],"prefix":"10.1111","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9567-0151","authenticated-orcid":false,"given":"Emi","family":"Kondo","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology National Hospital Organization Kokura Medical Center  Kitakyushu Japan"},{"name":"Department of Obstetrics and Gynecology Japan Community Healthcare Organization (JCHO) Kyushu Hospital  Kitakyushu Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mika","family":"Makimura","sequence":"additional","affiliation":[{"name":"Department of Pediatrics National Hospital Organization Kokura Medical Center  Kitakyushu Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kano","family":"Hayashi","sequence":"additional","affiliation":[{"name":"Department of Diabetes, Endocrinology and Metabolism National Hospital Organization Kokura Medical Center  Kitakyushu Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kosuke","family":"Kawakami","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology National Hospital Organization Kokura Medical Center  Kitakyushu Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takeshi","family":"Usui","sequence":"additional","affiliation":[{"name":"Department of Medical Genetics Shizuoka General Hospital  Shizuoka Japan"},{"name":"Shizuoka Graduate University of Public Health  Shizuoka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toshiyuki","family":"Yoshizato","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology National Hospital Organization Kokura Medical Center  Kitakyushu Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,2,22]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1507\/endocrj.EJ14-0377"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2019.00388"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/dmx014"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1210\/mend-5-5-685"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgad377"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12978-024-01874-2"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1530\/eje.0.1430397"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40348-020-00100-w"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2265.2000.00995.x"},{"key":"e_1_2_10_11_1","unstructured":"https:\/\/jmorp.megabank.tohoku.ac.jp\/genes\/1589?genome=GRCh38."}],"container-title":["Journal 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Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jog.70191","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jog.70191","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jog.70191","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T00:02:35Z","timestamp":1773014555000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/jog.70191"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2]]},"references-count":10,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,2]]}},"alternative-id":["10.1111\/jog.70191"],"URL":"https:\/\/doi.org\/10.1111\/jog.70191","archive":["Portico"],"relation":{},"ISSN":["1341-8076","1447-0756"],"issn-type":[{"value":"1341-8076","type":"print"},{"value":"1447-0756","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2]]},"assertion":[{"value":"2025-08-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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