We report a child in whom DOC excess secondary to congenital adrenal h
yperplasia (CAH, 11beta-hydroxylase deficiency) caused malignant hyper
tension. Clinical and metabolic control could be achieved only by repl
acement of both glucocorticoid and mineralocorticoid, thus confirming
in clinical practice the hypothesis that DOC is produced from both the
zonae fasciculata and glomerulosa of the adrenal cortex under the ind
ependent control of the ACTH and renin-angiotensin systems respectivel
y.