title: Adrenal steroids synthesis during acute infectious diseases in infants.
abstract: An increase in plasma 17OHP found in infants requiring differential diagnosis between septic shock and adrenal failure led us to look for adrenal steroids pattern during infection.
  
  
  METHODS
  56 infants, 1-6 months old, were studied during infection of different degrees of severity. Plasma cortisol, 17OHP, androstenedione, DHEA, DHEA-S and testosterone were measured.
  
  
  RESULTS
  24 patients showed an expected cortisol elevation. One child had a low cortisol level. The concentration of 17OHP was above 6.0 nmol/l (200 ng/dl) in 41 patients and above 30.2 nmol/l (1,000 ng/dl) in 10. Higher 17OHP levels and more severe diseases correlated positively.
  
  
  CONCLUSIONS
  During infectious diseases some patients demonstrated not only cortisol elevation but also 17OHP as high as that observed in NC-CAH. We suggest that if 17OHP elevation is not characteristic of SL-CAH, glucocorticoid therapy should be started and an ACTH test should be performed after recovery before ruling out this pathology.
authors.affiliation: Department of Pediatrics, Pediatric Endocrinology Unit, Santa Casa de São Paulo School of Medicine, University of São Paulo School of Medicine, São Paulo, Brazil.
authors.forename: C A
authors.initials: CA
authors.lastname: Longui
authors.forename: E R M
authors.initials: ER
authors.lastname: Zlochevsky
authors.forename: T A S S
authors.initials: TA
authors.lastname: Bachega
authors.forename: O
authors.initials: O
authors.lastname: Monte
mesh_terms: D019326:17-alpha-Hydroxyprogesterone / Q000097:blood*; D000208:Acute Disease; D000311:Adrenal Glands / Q000378:metabolism*; D000735:Androstenedione / Q000097:blood; D019314:Dehydroepiandrosterone Sulfate / Q000097:blood; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007030:Hypothalamo-Hypophyseal System / Q000502:physiology; D007223:Infant; D007239:Infections / Q000378:metabolism*; D008297:Male; D013739:Testosterone / Q000097:blood
chemical_list: D013739:Testosterone; D000735:Androstenedione; D019314:Dehydroepiandrosterone Sulfate; D019326:17-alpha-Hydroxyprogesterone; D006854:Hydrocortisone