Home monitoring of 17 hydroxyprogesterone levels in congenital adrenal hyperplasia with filter paper blood samples
Open accessAbstract
OBJECTIVE: The purpose of this study was to evaluate the usefulness of 17 hydroxyprogesterone (17OHP) determination in dried filter paper blood samples from patients with congenital adrenal hyperplasia caused by 21-hydroxylase deficiency. It was hypothesized that these home samples would enhance patient treatment. STUDY DESIGN: Results of 17OHP determination in simultaneously collected venous and dried filter paper blood samples were compared to establish assay reliability. Thereafter, parents mailed dried filter paper blood samples collected before each hydrocortisone dose. RESULTS: The 17OHP levels in wet and dried blood samples correlated well (r = 0.98). Results did not change when stored for 2 weeks under various conditions. Blood sampling at different times of the day provided insights into the patterns of 17OHP secretion and identified times of inadequate adrenal suppression. Dose adjustments were then made considering the time of day when adrenal suppression was inadequate. CONCLUSION: Home monitoring of 17OHP is a reliable and practical approach for assessing adrenal steroid activity in patients with congenital adrenal hyperplasia. Considering the time of day of 17OHP elevations also facilitates hydrocortisone dosing adjustment.
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Adrenal-specific metabolites such as 21-deoxycortisol and 11-oxygenated androgens may provide more direct evidence for adrenal androgen production in CAH.
“Adrenalspecific metabolites such as 21-deoxycortisol (387) and 11-oxygenated androgens (86) may provide more direct evidence for adrenal androgen production in CAH.”
From Congenital Adrenal Hyperplasia—Current Insights in Pathophysiology, Diagnostics, and Management (2022) · cites this paper as [387]
The Discussion describes 17OHP as a measure of adrenal suppression in CAH, but does not assess whether 21-deoxycortisol or 11-oxygenated androgens provide more direct evidence of adrenal androgen production. Searches for both named metabolites found no passage addressing that comparison in our copy; page numbers were not provided. (LLM, conf=0.76)
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- Authors
- Bode, H. H., Rivkees, S. A., Cowley, D. M., Pardy, K., & Johnson, S.
- Affiliations
- UNSW Sydney (AU)
- Venue
- The Journal of Pediatrics
- Publisher
- Elsevier BV
- Published
- 1999-02
- Volume
- 134
- Issue
- 2
- Pages
- 185-189
- ISSN
- 0022-3476 (ISSN-L)
- OpenAlex
- W2000854360
- Cited by
- 47
- References
- 13
- Citations by year
- 2024: 3 · 2023: 2 · 2022: 1 · 2021: 2 · 2019: 1 · 2018: 3 · 2016: 1 · 2015: 1 · 2014: 2 · 2012: 1
- FWCI
- 1.72
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- The Journal of Pediatrics (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Sexual Differentiation and Disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Clinical Biochemistry › Metabolism and Genetic Disorders
- Keywords
- congenital adrenal hyperplasia, 21-hydroxylase deficiency, 17-hydroxyprogesterone, home monitoring, adrenal suppression, diurnal variation, assay reliability
- MeSH terms
- Adolescent, Adrenal Hyperplasia, Congenital, Child, Child, Preschool, Circadian Rhythm, Female, Glucocorticoids, Humans, Infant, Male, Monitoring, Physiologic, Reagent Kits, Diagnostic, Reagent Strips, Self Care, 17-alpha-Hydroxyprogesterone
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