Urinary 17 alpha-hydroxyprogesterone in management of 21-hydroxylase deficiency.
OBJECTIVE
The study was designed to assess the reliability of measurement of 24-hour urinary 17 alpha-hydroxyprogesterone (17-OHP) by radio-immunoassay (RIA) as an alternative biochemical assessment for monitoring the treatment of congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency (21-OHD) and to assess the need for sample purification by column chromatography to improve assay specificity.


METHODS
Morning serum 17-OHP was measured using RIA and 24-hour urinary pregnanetriol using gas chromatography. Twenty-four-hour urinary 17-OHP was measured in samples from 17 prepubertal patients with CAH due to 21-OHD, and 20 normal prepubertal children as controls. In 24 urine samples, RIA of 17-OHP was performed with and without column chromatography.


RESULTS
There was a good correlation between 24-hour urinary 17-OHP and 24-hour urinary pregnanetriol (r = 0.962, P < 0.01) and between 24-hour urinary 17-OHP and morning serum 17-OHP (r = 0.955, P < 0.01). There was no significant difference in the RIA of the urine samples with and without purification by column chromatography.


CONCLUSIONS
The measurement of 24-hour urinary 17-OHP is a reliable alternative for the biochemical monitoring of 21-OHD, and RIA specificity is unaffected by omission of column chromatography.
Lim
Y J
YJ
Centre for Hormone Research, Royal Children's Hospital, Parkville, Victoria, Australia.
Yong
A B
AB
Warne
G L
GL
Montalto
J
J
D019326:17-alpha-Hydroxyprogesterone; D000312:Adrenal Hyperplasia, Congenital / Q000628:therapy* / Q000652:urine; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D002849:Chromatography, Gas / Q000191:economics; D002940:Circadian Rhythm; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D006908:Hydroxyprogesterones / Q000097:blood / Q000652:urine*; D007223:Infant; D008297:Male; D011237:Predictive Value of Tests; D011279:Pregnanetriol / Q000652:urine; D011863:Radioimmunoassay / Q000191:economics
D005938:Glucocorticoids; D006908:Hydroxyprogesterones; D011279:Pregnanetriol; D019326:17-alpha-Hydroxyprogesterone