{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T09:42:50Z","timestamp":1791538970531,"version":"4.3.4"},"reference-count":24,"publisher":"The Endocrine Society","issue":"12","license":[{"start":{"date-parts":[[2024,11,20]],"date-time":"2024-11-20T00:00:00Z","timestamp":1732060800000},"content-version":"vor","delay-in-days":13,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,11,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The increase in popularity of electronic cigarettes arouses great health concern. We describe a case of a 35-year-old female with chronic use of electronic cigarettes. She presented with secondary amenorrhea and prominent features of hyperandrogenism, including acne vulgaris, male-pattern alopecia, deepening of voice, and hirsutism. The initial biochemical workup revealed a profile indicating 11\u03b2-hydroxylase deficiency. However, genetic analysis did not show any evidence of CYP11B1 mutation. This patient manifested the florid signs of disrupted steroidogenesis brought by chronic use of electronic cigarette oil containing etomidate and propoxate\/isopropoxate, which are compounds structurally resembling etomidate. High clinical suspicion and sound understanding of the pharmacology and pathophysiology were instrumental in establishing the diagnosis for our present case.<\/jats:p>","DOI":"10.1210\/jcemcr\/luae207","type":"journal-article","created":{"date-parts":[[2024,10,25]],"date-time":"2024-10-25T07:20:20Z","timestamp":1729840820000},"source":"Crossref","is-referenced-by-count":6,"title":["Acquired 11\u03b2-hydroxylase Deficiency by Inhaled Etomidate and its Analogues: A Mimic of Congenital Adrenal Hyperplasia"],"prefix":"10.1210","volume":"2","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-1236-4204","authenticated-orcid":false,"given":"Choi Yee","family":"Lau","sequence":"first","affiliation":[{"name":"Department of Pathology, Queen Elizabeth Hospital , Hong Kong ,","place":["P. R. China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yee Ting Tommy","family":"Cheung","sequence":"additional","affiliation":[{"name":"Hospital Authority Toxicology Reference Laboratory, Department of Pathology, Princess Margaret Hospital , Hong Kong ,","place":["P. R. China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsz Mo Andrea","family":"Han","sequence":"additional","affiliation":[{"name":"Hospital Authority Toxicology Reference Laboratory, Department of Pathology, Princess Margaret Hospital , Hong Kong ,","place":["P. R. China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun Ming Jeremy","family":"Chung","sequence":"additional","affiliation":[{"name":"Department of Medicine and Geriatrics, Our Lady of Maryknoll Hospital , Hong Kong ,","place":["P.R. China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yeow Kuan","family":"Chong","sequence":"additional","affiliation":[{"name":"Hospital Authority Toxicology Reference Laboratory, Department of Pathology, Princess Margaret Hospital , Hong Kong ,","place":["P. R. China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0767-3163","authenticated-orcid":false,"given":"Pak Lam Sammy","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Pathology, Queen Elizabeth Hospital , Hong Kong ,","place":["P. R. China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","published-online":{"date-parts":[[2024,11,20]]},"reference":[{"issue":"4):","key":"2025010217281841300_luae207-B1","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1111\/cen.15009","article-title":"Rare forms of congenital adrenal hyperplasia","volume":"101","author":"Gurpinar Tosun","year":"2024","journal-title":"Clin Endocrinol (Oxf)"},{"issue":"1","key":"2025010217281841300_luae207-B2","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1007\/s12020-016-1189-x","article-title":"Clinical perspectives in congenital adrenal hyperplasia due to 11\u03b2-hydroxylase deficiency","volume":"55","author":"Bulsari","year":"2017","journal-title":"Endocrine"},{"issue":"1","key":"2025010217281841300_luae207-B3","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1111\/j.1749-6632.2002.tb04420.x","article-title":"Hypertension in congenital adrenal hyperplasia and apparent mineralocorticoid excess","volume":"970","author":"New","year":"2002","journal-title":"New York Acad Sci"},{"issue":"6","key":"2025010217281841300_luae207-B4","doi-asserted-by":"crossref","first-page":"1143","DOI":"10.1210\/jcem-59-6-1143","article-title":"Etomidate Suppresses Adrenocortical Function by Inhibition of 11 beta-Hydroxylation","volume":"59","author":"De Jong","year":"1984","journal-title":"J Clin Endocrinol Metab"},{"issue":"1","key":"2025010217281841300_luae207-B5","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1007\/s12024-023-00596-4","article-title":"The need to monitor emerging issues in etomidate usage: the misuse or abuse potential","volume":"20","author":"Uhm","year":"2024","journal-title":"Forensic Sci Med Pathol"},{"key":"2025010217281841300_luae207-B6"},{"key":"2025010217281841300_luae207-B7","doi-asserted-by":"crossref","DOI":"10.1007\/978-3-319-96364-8","volume-title":"Disorders of Steroidogenesis: Guide to Steroid Profiling and Biochemical Diagnosis","author":"Rumsby","year":"2019"},{"key":"2025010217281841300_luae207-B8","author":"National Center for Biotechnology Information"},{"key":"2025010217281841300_luae207-B9","author":"National Center for Biotechnology Information"},{"key":"2025010217281841300_luae207-B10","author":"National Center for Biotechnology Information"},{"key":"2025010217281841300_luae207-B11","author":"National Center for Biotechnology Information"},{"issue":"3","key":"2025010217281841300_luae207-B12","doi-asserted-by":"crossref","first-page":"695","DOI":"10.1097\/ALN.0b013e3181ff72b5","article-title":"Clinical and molecular pharmacology of etomidate","volume":"114","author":"Forman","year":"2011","journal-title":"Anesthesiology"},{"issue":"10","key":"2025010217281841300_luae207-B13","doi-asserted-by":"crossref","first-page":"1253","DOI":"10.1007\/s40262-021-01038-6","article-title":"Etomidate and its analogs: a review of pharmacokinetics and pharmacodynamics","volume":"60","author":"Valk","year":"2021","journal-title":"Clin Pharmacokinet"},{"issue":"8350","key":"2025010217281841300_luae207-B14","doi-asserted-by":"crossref","first-page":"626","DOI":"10.1016\/S0140-6736(83)90710-9","article-title":"Long-term etomidate and adrenocortical suppression","volume":"322","author":"Allolio","year":"1983","journal-title":"Lancet"},{"issue":"5","key":"2025010217281841300_luae207-B15","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1111\/j.1399-6576.1985.tb02238.x","article-title":"Etomidate infusion and adrenocortical function: a study in elective surgery","volume":"29","author":"Wanscher","year":"1985","journal-title":"Acta Anaesthesiol Scand"},{"key":"2025010217281841300_luae207-B16","doi-asserted-by":"crossref","first-page":"20420188211058583","DOI":"10.1177\/20420188211058583","article-title":"Pharmacological management of severe Cushing's syndrome: the role of etomidate","volume":"13","author":"Pence","year":"2022","journal-title":"Ther Adv Endocrinol Metab"},{"issue":"1","key":"2025010217281841300_luae207-B17","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1210\/js.2018-00269","article-title":"Continuous etomidate infusion for the management of severe cushing syndrome: validation of a standard protocol","volume":"3","author":"Carroll","year":"2019","journal-title":"J Endocr Soc"},{"issue":"4975","key":"2025010217281841300_luae207-B18","doi-asserted-by":"crossref","first-page":"1018","DOI":"10.1038\/2051018a0","article-title":"Propoxate (R7464)\u202f: a new potent anaesthetic agent in cold-blooded vertebrates","volume":"205","author":"Thienpont","year":"1965","journal-title":"Nature"},{"key":"2025010217281841300_luae207-B19"},{"issue":"3","key":"2025010217281841300_luae207-B20","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1055\/s-2002-35389","article-title":"Congenital adrenal hyperplasia: 11\u03b2-hydroxylase deficiency","volume":"20","author":"Peter","year":"2002","journal-title":"Semin Reprod Med"},{"issue":"5","key":"2025010217281841300_luae207-B21","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1038\/s41574-020-0336-x","article-title":"11-Oxygenated androgens in health and disease","volume":"16","author":"Turcu","year":"2020","journal-title":"Nat Rev Endocrinol"},{"key":"2025010217281841300_luae207-B22","author":"Dixon"},{"key":"2025010217281841300_luae207-B23"},{"key":"2025010217281841300_luae207-B24"}],"container-title":["JCEM Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jcemcr\/article-pdf\/2\/12\/luae207\/60966284\/luae207.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jcemcr\/article-pdf\/2\/12\/luae207\/60966284\/luae207.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,2]],"date-time":"2025-01-02T12:28:34Z","timestamp":1735820914000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jcemcr\/article\/doi\/10.1210\/jcemcr\/luae207\/7905228"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,7]]},"references-count":24,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2024,11,7]]}},"URL":"https:\/\/doi.org\/10.1210\/jcemcr\/luae207","relation":{},"ISSN":["2755-1520"],"issn-type":[{"value":"2755-1520","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2024,12]]},"published":{"date-parts":[[2024,11,7]]},"article-number":"luae207"}}