Skip to main content
NCBI home page
Archives of Disease in Childhood logoLink to Archives of Disease in Childhood
. 1984 Aug;59(8):743–747. doi: 10.1136/adc.59.8.743

Diurnal variation in blood 17-hydroxyprogesterone concentrations in untreated congenital adrenal hyperplasia.

J Sólyom
PMCID: PMC1628610  PMID: 6541026

Abstract

Blood spot 17-hydroxyprogesterone concentrations were measured serially over 24 hours in patients with congenital adrenal hyperplasia due to 21-hydroxylase deficiency before they started treatment with glucocorticoids, and the development of diurnal rhythm in pituitary-adrenal activity was studied. Five infants aged 2 to 26 days showed an intradiem variation of 17-hydroxyprogesterone concentrations within the diagnostic range but without a characteristic diurnal pattern. Blood spot 17-hydroxyprogesterone values in a further eight patients aged 3 months to 6.5 years showed a diurnal rhythm, with high concentrations in the morning and a nadir in the evening. The results suggest that a diurnal rhythm in pituitary-adrenal activity may develop as early as the third month of life in those infants with an increased endogenous concentration of adrenocorticotrophic hormone.

Full text

PDF
743

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Atherden S. M., Barnes N. D., Grant D. B. Circadian variation in plasma 17-hydroxyprogesterone in patients with congenital adrenal hyperplasia. Arch Dis Child. 1972 Aug;47(254):602–604. doi: 10.1136/adc.47.254.602. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Bacon G. E., Spencer M. L., Kelch R. P. Effect of cortisol treatment on hormonal relationships in congenital adrenal hyperplasia. Clin Endocrinol (Oxf) 1977 Feb;6(2):113–126. doi: 10.1111/j.1365-2265.1977.tb02002.x. [DOI] [PubMed] [Google Scholar]
  3. Cacciari E., Balsamo A., Cassio A., Piazzi S., Bernardi F., Salardi S., Cicognani A., Pirazzoli P., Zappulla F., Capelli M. Neonatal screening for congenital adrenal hyperplasia. Arch Dis Child. 1983 Oct;58(10):803–806. doi: 10.1136/adc.58.10.803. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Franks R. C. Diurnal variation of plasma 17-hydroxycorticosteroids in children. J Clin Endocrinol Metab. 1967 Jan;27(1):75–78. doi: 10.1210/jcem-27-1-75. [DOI] [PubMed] [Google Scholar]
  5. Frisch H., Parth K., Schober E., Swoboda W. Circadian patterns of plasma cortisol, 17-hydroxyprogesterone, and testosterone in congenital adrenal hyperplasia. Arch Dis Child. 1981 Mar;56(3):208–213. doi: 10.1136/adc.56.3.208. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Fukushima D. K., Finkelstein J. W., Yoshida K., Boyar R. M., Hellman L. Pituitary-adrenal activity in untreated congenital adrenal hyperplasia. J Clin Endocrinol Metab. 1975 Jan;40(1):1–12. doi: 10.1210/jcem-40-1-1. [DOI] [PubMed] [Google Scholar]
  7. Hubl W., Fehér T., Rohde W., Dörner G., Taubert H., Freymann E. Enzyme immunoassay of 17-hydroxyprogesterone in plasma, microfilter paper blood and saliva of newborns, children and patients with congenital adrenal hyperplasia. Endokrinologie. 1982 Jun;79(2):165–172. [PubMed] [Google Scholar]
  8. Hughes I. A., Winter J. S. The application of a serum 17OH-progesterone radioimmunoassay to the diagnosis and management of congenital adrenal hyperplasia. J Pediatr. 1976 May;88(5):766–773. doi: 10.1016/s0022-3476(76)81112-2. [DOI] [PubMed] [Google Scholar]
  9. Krieger D. T., Allen W., Rizzo F., Krieger H. P. Characterization of the normal temporal pattern of plasma corticosteroid levels. J Clin Endocrinol Metab. 1971 Feb;32(2):266–284. doi: 10.1210/jcem-32-2-266. [DOI] [PubMed] [Google Scholar]
  10. Murphy J. F., Joyce B. G., Dyas J., Hughes I. A. Plasma 17-hydroxyprogesterone concentrations in ill newborn infants. Arch Dis Child. 1983 Jul;58(7):532–534. doi: 10.1136/adc.58.7.532. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Nieschlag E., Wenner H., Breu H., Wickings E. J., Schellong G. Adrenogenitales Syndrom. Therapeutische Einstellung anhand des Tagesprofils des 17-Hydroxyprogesterons im Serum. Dtsch Med Wochenschr. 1980 Apr 25;105(17):600–603. doi: 10.1055/s-2008-1070713. [DOI] [PubMed] [Google Scholar]
  12. Onishi S., Miyazawa G., Nishimura Y., Sugiyama S., Yamakawa T., Inagaki H., Katoh T., Itoh S., Isobe K. Postnatal development of circadian rhythm in serum cortisol levels in children. Pediatrics. 1983 Sep;72(3):399–404. [PubMed] [Google Scholar]
  13. Pang S., Hotchkiss J., Drash A. L., Levine L. S., New M. I. Microfilter paper method for 17 alpha-hydroxyprogesterone radioimmunoassay: its application for rapid screening for congenital adrenal hyperplasia. J Clin Endocrinol Metab. 1977 Nov;45(5):1003–1008. doi: 10.1210/jcem-45-5-1003. [DOI] [PubMed] [Google Scholar]
  14. Pang S., Murphey W., Levine L. S., Spence D. A., Leon A., LaFranchi S., Surve A. S., New M. I. A pilot newborn screening for congenital adrenal hyperplasia in Alaska. J Clin Endocrinol Metab. 1982 Sep;55(3):413–420. doi: 10.1210/jcem-55-3-413. [DOI] [PubMed] [Google Scholar]
  15. Price D. A., Close G. C., Fielding B. A. Age of appearance of circadian rhythm in salivary cortisol values in infancy. Arch Dis Child. 1983 Jun;58(6):454–456. doi: 10.1136/adc.58.6.454. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Smith R., Donald R. A., Espiner E. A., Glatthaar C., Abbott G., Scandrett M. The effect of different treatment regimens on hormonal profiles in congenital adrenal hyperplasia. J Clin Endocrinol Metab. 1980 Aug;51(2):230–236. doi: 10.1210/jcem-51-2-230. [DOI] [PubMed] [Google Scholar]
  17. Sólyom J., Hervei S., Marossy P., Sólyom E., Babosa M., Szombathy G. "Dot-17 alpha-hydroxyprogesterone" radioimmunoassay for identification of congenital adrenal hyperplasia in young infants. Acta Paediatr Scand. 1981 Nov;70(6):913–917. doi: 10.1111/j.1651-2227.1981.tb06250.x. [DOI] [PubMed] [Google Scholar]
  18. Zipf W. B., Bacon G. E., Kelch R. P. Hormonal and clinical responses to prednisone treatment in adolescents with congenital adrenal hyperplasia. Horm Res. 1980;12(4):206–217. doi: 10.1159/000179122. [DOI] [PubMed] [Google Scholar]

Articles from Archives of Disease in Childhood are provided here courtesy of BMJ Publishing Group

RESOURCES