What condition is indicated by salt retention and hypertension?

The condition indicated by salt retention and hypertension is associated with 11-hydroxylase deficiency. This enzyme is crucial in the biosynthesis of cortisol and aldosterone in the adrenal cortex. In 11-hydroxylase deficiency, there is a block in the conversion of 11-deoxycortisol to cortisol and 11-deoxycorticosterone to corticosterone.

As a result of this enzymatic block, there is an accumulation of 11-deoxycorticosterone, which possesses mineralocorticoid activity. This leads to sodium retention, causing increasing blood volume and subsequently hypertension. The condition can also lead to features consistent with an androgen excess due to increased steroid precursors, but the key pathological features of this disorder are the salt retention and hypertension due to the mineralocorticoid effects of the accumulated metabolites.

Understanding this can help differentiate it from other conditions involving adrenal hormone synthesis. For example, in 21-hydroxylase deficiency, there is commonly a decrease in both cortisol and aldosterone, leading to salt-wasting and compensatory hyperplasia of the adrenal cortex, along with virilization due to increased adrenal androgens. Conversely, in 17-hydroxylase deficiency, there