DETERMINATIONS OF PLASMA TESTOSTERONE (T) , 17-OH ROGESTERONE(17-OHP), ACTH & RENIN ACTIVITY (R.A) in THE TREATMENT CONTROL OF CONGENITAL ADRENAL HYPERPLASIA DUE TO C-21 HYDROXYLASE DEFICIENCY (C-21 AH)

摘要

These parameters were determined in 34 children and adolescents with C-21 AH, during 2 years period. Blood samples were obtained between 6 and 9 a.m. on fasting individuals after one night of rest at the hospital. Elevated levels of T were observed before treatment or when the glucocorticoid doses were in sufficient. In some cases, starting or raising the mineralocorticoid treatment (9 alpha fluorocortisol) was followed by a decrease in T levels. High levels of R. A. were constantly found before treatment, even in the absence of salt losing syndrome. In some cases treated by glucocorticoid and salt. R.A. levels remained elevated: appropriated doses of 9 alpha|fluorocortisol induced a marked decrease in R.A. levels. Elevated 17-OH levels were always present before treatment, but frequently failed to normalize under therapy. Important individual variations were ibserved from day today and in the same day. As far as ACTH is concerned, our data are too inconsistnet to take into account this parameter. Regular determinations of plasma T and R. A. allow us a better control of glucocorticoid therapy (our mean dose being 19 mg hydrocortisone/m2/day which is lower than dosages usually published) and of skeletal maturation (however, none of this infants followed since birth are older than two years).