Mutations in 21 hydroxylase gene were investigated in 40 Russian patients with congenital adrenal hyperplasia. Quantitative amplification/restriction procedure was used for detection of mutations involving promoter region, 3 and 8 exons. For affected chromosomes alleles of tightly linked HLA A and B genes were defined, as well as 5 different alleles or allele combinations HLA DQA1 gene. The most frequent (> 20% of chromosomes) cause of salt wasting adrenal hyperplasia in Russia is a chimeric CYP21A-CYP21B gene with normal copy of a pseudogene which results from gene conversion in chromosome with B14-DQA1 0101/0102 haplotype. The second common mutation (about 10%) is a result of intragenic recombination well-known deletion of the gene linked with A3-B47-DQA1 0201/0601 haplotype. Two other mutations were linked with A3-B35-DQA1 0401/0402 and A3-B40-DQA1 0201/0601 haplotypes.

Three young girls of short stature and with somatic anomalies typical for the Shereshevsky-Turner syndrome are described. Signs of sexual maturation and menarche appeared on time. Later on, menstrual periods came to resemble juvenile bleedings. Karyotypes determined in lymphocyte culture were 45,X/46,XX/47,XXX; 45,X/46,XXp-; and 46,XXp-, respectively. A possibility of spontaneous sexual maturation in patients with the Shereshevsky-Turner syndrome is discussed.

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