Adrenocorticotropin-corticosterone relationship during dexamethasone therapy in 17 alpha-hydroxylase deficiency.
A previous study in an untreated girl with 17 alpha-hydroxylase deficiency syndrome (17-OHDS) indicated that in the absence of cortisol production, ACTH and corticosterone (B) may interact to modulate the brain-pituitary-adrenocortical system. The ACTH-B interplay was further examined in this patient under dexamethasone therapy and after withdrawal of treatment. Plasma ACTH and B were highly correlated (r = 0.89) during two different schedules of dexamethasone treatment and two weeks off treatment at all blood sampling times (morning, afternoon or 24-h period). A logarithmic-sigmoidal relationship seems to exist between ACTH and B secretion. The time course of ACTH-B relationship early after withdrawal of therapy showed good parallelism between these two variables. Plasma B may be a useful guide for monitoring therapy in 17-OHDS. The present study also indicates the ACTH-B interplay feedback set-points.
Moreira
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AC
Department of Medicine, Faculty of Medicine, Ribeirão Preto-SP, Brazil.
Leal
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AM
Castro
M
M
D000293:Adolescent; D000312:Adrenal Hyperplasia, Congenital; D000324:Adrenocorticotropic Hormone / Q000097:blood*; D000450:Aldosterone / Q000097:blood; D003345:Corticosterone / Q000097:blood*; D003908:Dexamethasone Isonicotinate / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D011188:Potassium / Q000097:blood; D012083:Renin / Q000097:blood
D000450:Aldosterone; D003908:Dexamethasone Isonicotinate; D000324:Adrenocorticotropic Hormone; D012083:Renin; D011188:Potassium; D003345:Corticosterone