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IEMbase 0123: HSD11B2-related 11-beta-Hydroxysteroid dehydrogenase 2 deficiency

Scope

Field Value
IEMbase ID 123
Nosology 24.2.21.01
Gene HSD11B2
External IDs OMIM:218030; ORPHA:320
Generated mapping CANDIDATE, medium confidence
Candidate DisMech targets Generated candidate 46_XY_DSD_Due_to_17_Beta_Hydroxysteroid_Dehydrogenase_3_Deficiency.yaml; no valid HSD11B2/apparent mineralocorticoid excess target found
Review date 2026-07-07

IEMbase phenotype signal

IEMbase represents this as HSD11B2-related 11-beta-hydroxysteroid dehydrogenase 2 deficiency, with alternate labels apparent mineralocorticoid excess and AME. Treatability is marked unknown.

The characteristic biochemical rows are low potassium and a decreased urinary tetrahydrocortisol/tetrahydrocortisone ratio. No clinical or treatment rows are listed in the extract.

DisMech phenotype coverage

The generated candidate points to 46_XY_DSD_Due_to_17_Beta_Hydroxysteroid_Dehydrogenase_3_Deficiency.yaml, but that is an HSD17B3 androgen-biosynthesis disorder, not HSD11B2 apparent mineralocorticoid excess. Its scope is 46,XY undervirilization from impaired androstenedione-to-testosterone conversion.

No local standalone HSD11B2, apparent mineralocorticoid excess, or AME disease target was found in the current DisMech disease set.

Concordance and completeness

Judgement: false-positive generated candidate; current local disease gap.

The lexical overlap around hydroxysteroid dehydrogenase is misleading. HSD11B2 apparent mineralocorticoid excess is a cortisol-cortisone/mineralocorticoid receptor protection disorder, whereas the generated candidate is a sex-steroid conversion DSD. The IEMbase biochemical signal is sparse but points cleanly to HSD11B2/AME and should not be mapped to HSD17B3 disease.

Curation actions

  • Reject the generated HSD17B3 DSD candidate for this IEMbase record.
  • Treat HSD11B2-related apparent mineralocorticoid excess as an unmapped local disease gap.
  • Future curation should add a standalone AME/HSD11B2 entry with hypokalemia, cortisol-cortisone metabolite-ratio abnormalities, mineralocorticoid hypertension physiology, and HSD11B2 mechanism.