Serum 17-α-hydroxyprogesterone, progesterone, estradiol, and testosterone in the diagnosis and management of congenital adrenal hyperplasia

Lippe, Barbara M.; LaFranchi, Stephen; Lavin, Norman; Parlow, Albert F.; Coyotupa, Juan; Kaplan, Solomon A.

doi:10.1016/s0022-3476(74)80340-9

Cited by 90 publications

(26 citation statements)

References 14 publications

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“…PIasma P reference levels to date have been reported in only very small numbers of infants (35,54) and prepubertal children not subdivided into different age groups (1, 3,25,35,54). The P levels throughout infancy and childhood agree favorably with these data.…”

Section: Progestinssupporting

confidence: 61%

Plasma Levels of Aldosterone, Corticosterone, 11-Deoxycorticosterone, Progesterone, 17-Hydroxyprogesterone, Cortisol, and Cortisone During Infancy and Childhood

Sippell¹,

Dörr²,

Bidlingmaier³

et al. 1980

Pediatr Res

147

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Summaryother mineralocorticoids like DOC, and glucocorticoids like B and E exhibit similar patterns in different p&iatric age groups or not. Plasma aldosterone (A), corticosterone (B), deoxycorticoster-~~~~~~l~ published data on the progestins P and 1 7 -0~p with One progesterone ( ' 1,, one exception (23) during the large quantities of blood previously required for their deterthe first weeks of life, then increased significantly reaching adult mination and the sampling difficulties encountered in young levels between v of 'gee Mean progressive'y from 74 children. It prompted us to study these important parameters of after birth to l0 during Yr (' << O.OOO1), then adrenocortical function in a large number of children 'lightly increased to levels-After age yr, ' and 17-OHP, throughout all pediatric age groups using our recently developed in contrast to the other steroids, rose significantly in both boys method for the simultaneous determination of eight plasma steand girls relative to pubertal development.roids by radioimmunoassay (46) requiring only 1-3 ml of periphThe observed changes are thought to be due to (1) adaptation eral blood. of the adrenal neocortex to extrauterine life after disruption of the fetoplacental unit, (2) a physiologic lack of corticosteroid binding globulin (CBC) during infancy due to maturation of hepatic MATERIALS AND METHODS CBG biosynthesis, (3) the functional immaturity of the infant kidney compensated by an increased activity of the renin-angio-A total of 174 infants and (83 boys and 91 girls), aged tensin-aldosterone system, and (4) gradually increasing gonadal * hr-15 yr* were studied' The newborn infants were products secretion of progestins during puberty. of uncomplicated, full term pregnancies and were born by vaginal delivery after labor of spontaneous onset. Infants and children over 2 wk of age were either admitted for minor disorders or for Speculation observation, or were seen at the Outpatient Department and From birth to adulthood, marked evolutional changes were required VenepUnCtUre for diagnostic reasons. In addition, inobserved in the basal plasma concentrations of all physiologically formed consent was obtained from the mothers, fathers, or guardimportant unconjugated corticosteroids and progestins in normal ians. In the two oldest age groups (7-15 yr), there were 26 boys children. Detailed knowledge of the agedependent normal plasma and 26 girls whose pubertal development (53) ranged from Stage steroid pattern reflecting maturational processes of both the hy-1 -4 9 and from Stage 1-59 respectively. Only 5 of these girls were pothalamo-adrenocortical and the hypothalamo-gonadal axis, of after menarche. ,411 subjects included in the present study were the renin-angiotensin-aldosterone system, and of hepatic and renal without evidence of endocrine, renal, circulatory, or any other function, therefore, is a prerequisite for understanding pathologic systemic disease and did not show disturbances of acid base or conditions in pediatric endocrinology.electrolyte metab...

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Section: Progestinssupporting

confidence: 61%

Plasma Levels of Aldosterone, Corticosterone, 11-Deoxycorticosterone, Progesterone, 17-Hydroxyprogesterone, Cortisol, and Cortisone During Infancy and Childhood

Sippell¹,

Dörr²,

Bidlingmaier³

et al. 1980

Pediatr Res

147

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“…First, the majority of studies have shown good correlation between 17OHP, androstenedione, and testosterone concentrations in a single blood sample, indicating that these hormone concentrations are all under similar influences (26 ). Second, random measurement of a single value of 17OHP is generally not beneficial and does not correlate with any other marker of control (14,17,19,20,26,27 ). A concentration that is extremely high (Ͼ40 nmol/L) indicates undertreatment.…”

Section: Serum Monitoringmentioning

confidence: 99%

Monitoring of Therapy in Congenital Adrenal Hyperplasia

Dauber¹,

Kellogg

Majzoub³

2010

Clinical Chemistry

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BACKGROUND:Congenital adrenal hyperplasia is a group of disorders caused by defects in the adrenal steroidogenic pathways. In its most common form, 21-hydroxylase deficiency, patients develop varying degrees of glucocorticoid and mineralocorticoid deficiency as well as androgen excess. Therapy is guided by monitoring clinical parameters as well as adrenal hormone and metabolite concentrations. CONTENT:We review the evidence for clinical and biochemical parameters used in monitoring therapy for congenital adrenal hyperplasia. We discuss the utility of 24-h urine collections for pregnanetriol and 17-ketosteroids as well as serum measurements of 17-hydroxyprogesterone, androstenedione, and testosterone. In addition, we examine the added value of daily hormonal profiles obtained from salivary or bloodspot samples and discuss the limitations of the various assays.

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“…The papers that the report refers to regarding the PR of estradiol (14) and progesterone (15) in prepubertal boys, and the PR of testosterone in prepubertal girls (11,13) do not give any information on the MCRs or PRs in healthy prepubertal children. They do, however, give information on the plasma concentrations of these hormones in children.…”

Section: Endogenous Production Of Sex Steroids In Humans Especially mentioning

confidence: 99%

Exposure to exogenous estrogens in food: possible impact on human development and health

1999

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There has been increasing concern about the impact of environmental compounds with hormone-like action on human development and reproductive health over the past decades. An alternative but neglected source of hormone action that may be considered in this connection is hormone residues in meat from husbandry animals treated with sex steroid hormones for growth promotion. Treatment of cattle with naturally occurring or synthetic sex hormones may enhance lean muscle growth and improve feed efficiency and is therefore a very cost effective procedure for cattle producers who have used it for decades in some Western countries, including the USA and Canada. The Joint Food and Agricultural Organisation/World Health Organisation (FAO/WHO) expert committee on food additives (JECFA) and the US Food and Drug Administration (FDA) considered, in 1988, that the residues found in meat from treated animals were safe for the consumers.We have re-evaluated the JECFA conclusions regarding the safety of estradiol residues in meat in the light of recent scientific data, with special emphasis on estradiol levels in prepubertal children. These levels are needed for estimates of the normal daily production rates of estradiol in children, who may be particularly sensitive to low levels of estradiol.In our opinion, the conclusions by JECFA concerning the safety of hormone residues in meat seem to be based on uncertain assumptions and inadequate scientific data. Our concerns can be summarized as follows. 1) The data on residue levels in meat were based on studies performed in the 1970 s and 1980 s using radioimmunoassay (RIA) methods available at the time. The sensitivity of the methods was generally inadequate to measure precisely the low levels found in animal tissues, and considerable variation between different RIA methods for measuring steroids exists. Therefore the reported residue levels may be subject to considerable uncertainty. 2) Only limited information on the levels of the various metabolites of the steroids was given despite the fact that metabolites also may have biological activity. 3) Reliable data on daily production rates of steroid hormones were and are still lacking in healthy prepubertal children. This lack is crucial as previous guidelines regarding acceptable levels of steroid residues in edible animal tissues have been based on very questionable estimates of production rates in children. Thus, even today the US FDA bases its guidelines on the presumably highly overestimated production rates in prepubertal children given in the JECFA 1988 report. 4) The possible biological significance of very low levels of estradiol is neglected.In conclusion, based on our current knowledge possible adverse effects on human health by consumption of meat from hormone-treated animals cannot be excluded.

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Serum 17-α-hydroxyprogesterone, progesterone, estradiol, and testosterone in the diagnosis and management of congenital adrenal hyperplasia

Cited by 90 publications

References 14 publications

Plasma Levels of Aldosterone, Corticosterone, 11-Deoxycorticosterone, Progesterone, 17-Hydroxyprogesterone, Cortisol, and Cortisone During Infancy and Childhood

Plasma Levels of Aldosterone, Corticosterone, 11-Deoxycorticosterone, Progesterone, 17-Hydroxyprogesterone, Cortisol, and Cortisone During Infancy and Childhood

Monitoring of Therapy in Congenital Adrenal Hyperplasia

Exposure to exogenous estrogens in food: possible impact on human development and health

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