URINARY 17-ALPHA-HYDROXYPROGESTERONE IN MANAGEMENT OF 21-HYDROXYLASE DEFICIENCY

Objectives: The study was designed to assess the reliability of measur ement of 24-hour urinary 17alpha-hydroxyprogesterone (17-OHP) by radio -immunoassay (RIA) as an alternative biochemical assessment for monito ring the treatment of congenital adrenal hyperplasia (CAH) due to 21-h ydroxylase deficiency (21-OHD) and to assess the need for sample purif ication by column chromatography to improve assay specificity. Methodo logy: Morning serum 17-OHP was measured using RIA and 24-hour urinary pregnanetriol using gas chromatography. Twenty-four-hour urinary 17-OH P was measured in samples from 17 prepubertal patients with CAH due to 21-OHD, and 20 normal prepubertal children as controls. In 24 urine s amples, RIA of 17-OHP was performed with and without column chromatogr aphy. Results: There was a good correlation between 24-hour urinary 17 -OHP and 24-hour urinary pregnanetriol (r = 0.962, P<0.01) and between 24-hour urinary 17-OHP and morning serum 17-OHP (r = 0.955, P<0.01). There was no significant difference in the RIA of the urine samples wi th and without purification by column chromatography. Conclusions: The measurement of 24-hour urinary 17-OHP is a reliable alternative for t he biochemical monitoring of 21-OHD, and RIA specificity is unaffected by omission of column chromatography.