As 21-hydroxylase deficiency (21-OHD) only affects adrenal steroidogenesis and 17 alpha-hydroxylase involves in both adrenal and gonadal steroid production and POR mutations have disruptive effects on both CYP21A2 and CYP17A1, multiple hormonal derangements can be observed in PORD by serum and urinary sampling analysis, reflecting altered steroid biosynthesis and metabolism (58). This evidence concerns the gene CYP21A2 and congenital adrenal hyperplasia due to cytochrome P450 oxidoreductase deficiency.