PMID- 8816616
OWN - NLM
STAT- MEDLINE
DCOM- 19961024
LR  - 20190707
IS  - 0015-0282 (Print)
IS  - 0015-0282 (Linking)
VI  - 66
IP  - 4
DP  - 1996 Oct
TI  - Overdiagnosis of 21-hydroxylase late onset congenital adrenal hyperplasia: 
      correlation of corticotropin test and human leukocyte antigen typing.
PG  - 557-63
AB  - OBJECTIVE: To evaluate the reliability of the ACTH test as a means for detection 
      of late onset congenital adrenal hyperplasia (CAH) and discriminating it from 
      polycystic ovary syndrome (PCOS), by repeating the test after 6 months of 
      cyproterone acetate and ethinyl E2 treatment. DESIGN: Follow-up comparison study. 
      SETTING: Reproductive Endocrinology in an university tertiary center. PATIENTS: 
      Thirty-one young women with hirsutism, oligoamenorrhea, and acne, 21 of them 
      detected as late onset CAH, and 10 as non-late onset CAH (PCOS). INTERVENTION: 
      Cyproterone acetate and ethinyl E2 treatment for > or = 6 months. The ACTH test, 
      before and after 6 months of cyproterone acetate + ethinyl E2 treatment, and 
      human leukocyte antigen (HLA) typing. MAIN OUTCOME MEASURE: The ACTH test 
      interpretation correlated to HLA typing. RESULTS: By repeating the ACTH 
      stimulation test in the 31 women (after cyproterone acetate + ethinyl E2 
      administration), we found a diminution in the rate of accumulation of 17 
      alpha-hydroxyprogesterone (delta 17-OHP) + P, in all 21-hydroxylase late onset 
      CAH cases. As a result of treatment with cyproterone acetate + ethinyl E2, a 
      decrease in the accumulation rate of 17-OHP + P, below the discriminative value 
      for late onset CAH (6.5 ng/dL per minute), was noted among 12 of 21 women defined 
      primarily as late onset CAH. Among the nine other women, a decrease in the 
      accumulation rate of 17-OHP + P was noted, however not < 6.5 ng/dL per minute. 
      CONCLUSIONS: The interpretation of delta 17-OHP + P for the diagnosis of late 
      onset CAH may be too sensitive as to the correct clinical diagnosis of late onset 
      CAH. By repeating the ACTH test after 6 months of treatment with cyproterone 
      acetate-ethinyl E2, specificity and accuracy may be improved.
FAU - Avivi, I
AU  - Avivi I
AD  - Rambam Medical Center, Bruce Rappaport Faculty of Medicine, Technion-Israel 
      Institute of Technology, Haifa, Israel.
FAU - Pollack, S
AU  - Pollack S
FAU - Gideoni, O
AU  - Gideoni O
FAU - Linn, S
AU  - Linn S
FAU - Blumenfeld, Z
AU  - Blumenfeld Z
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - United States
TA  - Fertil Steril
JT  - Fertility and sterility
JID - 0372772
RN  - 0 (Hydroxyprogesterones)
RN  - 423D2T571U (Ethinyl Estradiol)
RN  - 4G7DS2Q64Y (Progesterone)
RN  - 4KM2BN5JHF (Cyproterone Acetate)
RN  - 68-96-2 (17-alpha-Hydroxyprogesterone)
RN  - 9002-60-2 (Adrenocorticotropic Hormone)
SB  - IM
CIN - Fertil Steril. 1997 Jul;68(1):182; author reply 183-4. PMID: 9207612
CIN - Fertil Steril. 1997 Jul;68(1):183; discusssion 183-4. PMID: 9207613
MH  - 17-alpha-Hydroxyprogesterone
MH  - Adolescent
MH  - *Adrenal Hyperplasia, Congenital/*diagnosis
MH  - *Adrenocorticotropic Hormone
MH  - Adult
MH  - Cyproterone Acetate/pharmacology
MH  - Ethinyl Estradiol/pharmacology
MH  - Female
MH  - Follow-Up Studies
MH  - *Histocompatibility Testing
MH  - Humans
MH  - Hydroxyprogesterones/blood
MH  - Progesterone/blood
EDAT- 1996/10/01 00:00
MHDA- 1996/10/01 00:01
CRDT- 1996/10/01 00:00
PHST- 1996/10/01 00:00 [pubmed]
PHST- 1996/10/01 00:01 [medline]
PHST- 1996/10/01 00:00 [entrez]
AID - S0015-0282(16)58567-7 [pii]
AID - 10.1016/s0015-0282(16)58567-7 [doi]
PST - ppublish
SO  - Fertil Steril. 1996 Oct;66(4):557-63. doi: 10.1016/s0015-0282(16)58567-7.