title: 170H-progesterone rhythms in congenital adrenal hyperplasia.
abstract: Serial blood spot and saliva samples were collected at home by 18 patients being treated for congenital adrenal hyperplasia to determine the circadian rhythm of 170H-progesterone as an index of therapeutic control. There was a strong correlation between the magnitude of the circadian fall and a single morning measurement of the plasma testosterone concentration taken near the time of the 170H-progesterone rhythm samples. Poor control in pubertal girls produced an exaggerated circadian fall in 170H-progesterone concentrations that were raised at all sampling times. Optimal control (plasma testosterone 1.5-2.5 nmol/l) was associated with blood spot and salivary 170H-progesterone concentrations at 0800 hours of between 30-70 nmol/l and 260-1000 pmol/l, respectively, falling thereafter to less than 10 nmol/l and less than 150 pmol/l, respectively. Similar results were obtained in prepubertal patients. Nomograms have been constructed to interpret the daily profiles of blood spot or salivary measurements of 170H-progesterone, or both. The analysis of 170H-progesterone circadian rhythms is useful in monitoring treatment in patients with congenital adrenal hyperplasia, particularly those who may be overtreated.
authors.affiliation: Department of Child Health, University of Wales College of Medicine, Cardiff.
authors.forename: M C
authors.initials: MC
authors.lastname: Young
authors.forename: J A
authors.initials: JA
authors.lastname: Robinson
authors.forename: G F
authors.initials: GF
authors.lastname: Read
authors.forename: D
authors.initials: D
authors.lastname: Riad-Fahmy
authors.forename: I A
authors.initials: IA
authors.lastname: Hughes
mesh_terms: D019326:17-alpha-Hydroxyprogesterone; D000293:Adolescent; D000312:Adrenal Hyperplasia, Congenital / Q000378:metabolism*; D000328:Adult; D002648:Child; D002675:Child, Preschool; D002940:Circadian Rhythm; D005260:Female; D006801:Humans; D006908:Hydroxyprogesterones / Q000097:blood / Q000378:metabolism*; D008297:Male; D011627:Puberty / Q000378:metabolism; D012463:Saliva / Q000378:metabolism; D013739:Testosterone / Q000097:blood
chemical_list: D006908:Hydroxyprogesterones; D013739:Testosterone; D019326:17-alpha-Hydroxyprogesterone