Treatment of congenital virilizing adrenal hyperplasia patients with single and multiple daily doses of prednisone.
Six patients with congenital virilizing adrenal hyperplasia were evaluated on single- and multiple-dose prednisone schedules. Each of the treatment periods was for one month. Patients were evaluated by 24-hour urinary excretion of 17-ketosteroids and pregnanetriol, as well as 0900 plasma concentrations of 17-hydroxyprogesterone, progesterone, and testosterone. By the criteria of urinary excretion of KS and PNT appropriate for chronologic age, three of the six patients were adequately controlled on prednisone given once a day. Prednisone administered twice daily at 12-hourly intervals either in equally divided doses or with a larger dose in the evening, however, resulted in adequate suppression in all patients. Because of the marked diurnal variation of plasma 17-OHP, the time of day that the sample is drawn is critical. Afternoon samples are often misleadingly low. Plasma 17-OHP concentration may reflect escape from therapeutic control sooner than urinary KS and PNT excretion. There was no correlation between 17-OHP and P values. Plasma concentration of T was not a reliable indicator of good control, since T values were often at prepubertal levels when urinary KS and PNT were elevated.
D015068:17-Ketosteroids / Q000652:urine; D000293:Adolescent; D000312:Adrenal Hyperplasia, Congenital; D000308:Adrenocortical Hyperfunction / Q000188:drug therapy; D002648:Child; D002675:Child, Preschool; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D006908:Hydroxyprogesterones / Q000097:blood; D008297:Male; D011241:Prednisone / Q000008:administration & dosage* / Q000627:therapeutic use; D011279:Pregnanetriol / Q000652:urine; D011374:Progesterone / Q000097:blood; D013739:Testosterone / Q000097:blood
D015068:17-Ketosteroids; D006908:Hydroxyprogesterones; D011279:Pregnanetriol; D013739:Testosterone; D011374:Progesterone; D011241:Prednisone