Romo, Karina G.Shu, Sharon W.Iqbal, Qasim Z.Uwaifo, Gabriel I.2024-06-112024-06-112024-02-23Romo KG, Shu SW, Iqbal QZ, Uwaifo GI. Nonclassic Congenital Adrenal Hyperplasia Metabolic Resolution Post Roux-en-Y Gastric Bypass and Associated Weight Loss. JCEM Case Rep. 2024;2(3):luae018. Published 2024 Feb 23. doi:10.1210/jcemcr/luae018https://hdl.handle.net/1805/41410Nonclassic congenital adrenal hyperplasia (NCCAH) is characterized by mild cortisol deficiency, excess androgens and adrenocorticotropin (ACTH) production, and often with various features of dysmetabolic syndrome. Elective bariatric surgery is one of the most effective long-term management strategies for severe obesity. Our case presents a 34-year-old woman with symptomatic NCCAH and class III obesity who status post Roux-en-Y gastric bypass (RYGB) had significant weight loss with metabolic resolution of NCCAH, and no longer required glucocorticoid (GC) therapy. At 11 months post operation and off GC therapy, she had a weight deficit of approximately 160 pounds (72.57 kg) with continued metabolic resolution of NCCAH markers including ACTH, 17-hydroxyprogesterone, and androstenedione. Presently, GC therapy remains one of the few available treatments for symptomatic NCCAH; however, long-term GC therapy has the potential for various complications and side effects. Our case presents elective bariatric surgery as a potential and unique treatment option for patients with NCCAH with associated class III obesity. The exact pathophysiologic basis for this effect and its potential role in long-term management of appropriate NCCAH patients requires further study.en-USAttribution 4.0 InternationalNonclassic congenital adrenal hyperplasiaRoux-en-Y gastric bypassMorbid obesityClass III obesityBariatric surgeryMassive weight lossArticle