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Urinary and Serum Steroid Concentrations in the Management of Congenital Adrenal HyperplasiaLack of Physiologic Correlations
S. Anne Hendricks, MD;
Barbara M. Lippe, MD;
Solomon A. Kaplan, MD;
Norman Lavin, MD;
Darrell M. Mayes, PhD
Am J Dis Child. 1982;136(3):229-232.
Abstract
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• Serum concentrations of 17-hydroxyprogesterone, dehydroepiandrosterone, dehydroepiandrosterone sulfate, progesterone, testosterone, and androstenedione and 24-hour excretion of 17--ketosteroids and pregnanetriol were measured serially in 18 children with congenital adrenal hyperplasia (21-hydroxylase deficiency) during a two-year period. Correlations were sought between results of measurements of these steroids and clinical progress assessed by physical examination and skeletal maturity to determine if measurement of concentration of these substances at a single point in time could be used to gauge the dose of corticosteroids for optimum treatment. We found that these measurements of steroids were generally not useful indicators of optimum control of the disease. Repeated careful clinical examination and assessment of changes in growth velocity and skeletal maturation seem to be the best criteria on which to base dosage of corticosteroids used for therapy.
(Am J Dis Child 1982;136:229-232)
Author Affiliations
From the Department of Pediatrics, UCLA Center for the Health Sciences (Drs Hendricks, Lippe, and Kaplan) and the Research Division, Endocrine Sciences, Los Angeles (Drs Lavin and Mayes). Dr Hendricks is now with the National Institutes of Health, Bethesda, Md.
Footnotes
Reprint requests to Department of Pediatrics, Division of Endocrinology and Metabolism, UCLA Center for the Health Sciences, Los Angeles, CA 90024 (Dr Lippe).
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