Adrenal steroids synthesis during acute infectious diseases in infants.
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.
Longui
C A
CA
Department of Pediatrics, Pediatric Endocrinology Unit, Santa Casa de São Paulo School of Medicine, University of São Paulo School of Medicine, São Paulo, Brazil.
Zlochevsky
E R M
ER
Bachega
T A S S
TA
Monte
O
O
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
D013739:Testosterone; D000735:Androstenedione; D019314:Dehydroepiandrosterone Sulfate; D019326:17-alpha-Hydroxyprogesterone; D006854:Hydrocortisone