21-hydroxylase deficiency laboratory findings: Difference between revisions

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{{CMG}}; '''Associate Editor-In-Chief:''' {{MJ}}
{{CMG}}; '''Associate Editor-In-Chief:''' {{MJ}}
==Overview==
==Overview==
Laboratory findings consistent with the diagnosis of 21-hydroxylase deficiency differs in each disease type. [[17-hydroxyprogesterone]] level and [[Cosyntropin|cosintropin]] stimulation test can be used to diagnosis.
Laboratory findings consistent with the diagnosis of 21-hydroxylase deficiency differs in each disease type. [[17-hydroxyprogesterone]] level and [[cosyntropin]] stimulation test can be used to diagnosis.


==Laboratory Findings==
==Laboratory Findings==
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{| class="wikitable"
{| class="wikitable"
!21-hydroxylase deficiency type
!21-hydroxylase deficiency type
!17-hydroxyprogesterone level
![[17-hydroxyprogesterone]] level
!Cosintropin stimulation testing in high-dose test (250 mcg)
![[Cosyntropin|Cosintropin]] stimulation testing in high-dose test (250 mcg)
|-
|-
|Classic salt wasting
|Classic salt-wasting
|
|
* Greater than 3500 ng/dL
* Greater than 3500 ng/dL
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* Not necessary
* Not necessary
|-
|-
|Classic non-salt wasting
|Classic non salt-wasting
|
|
* Greater than 3500 ng/dL
* Greater than 3500 ng/dL
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|
|
* Children greater than 82 ng/dL  
* Children greater than 82 ng/dL  
* Adult female greater than 200 ng/dL, morning serum sample during the follicular phase of the menstrual cycle  
* Adult female greater than 200 ng/dL, morning serum sample during the [[follicular phase]] of the [[menstrual cycle]]
|
|
* Needs for confirmation
* Needs for confirmation
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===Salt-wasting crises in infancy in classic type===
===Salt-wasting crises in infancy in classic type===
* Low serum cortisol level
* Low serum [[cortisol]] level
* [[hyponatremia]], with a serum Na<sup>+</sup> typically between 105 and 125 mEq/L
* [[hyponatremia]], with a serum [[sodium]] typically between 105 and 125 mEq/L
* [[Hyperkalemia]] in these infants can be very high
* [[Hyperkalemia]] in these infants can be very high
* Metabolic acidosis
* [[Metabolic acidosis]]
* [[Hypoglycemia]]
* [[Hypoglycemia]]


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}

Revision as of 17:15, 1 August 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Mehrian Jafarizade, M.D [2]

Overview

Laboratory findings consistent with the diagnosis of 21-hydroxylase deficiency differs in each disease type. 17-hydroxyprogesterone level and cosyntropin stimulation test can be used to diagnosis.

Laboratory Findings

Laboratory findings consistent with the diagnosis of congenital adrenal hyperplasia due to 21-hydroxylase deficiency differs in each disease type.[1][2]

21-hydroxylase deficiency type 17-hydroxyprogesterone level Cosintropin stimulation testing in high-dose test (250 mcg)
Classic salt-wasting
  • Greater than 3500 ng/dL
  • Not necessary
Classic non salt-wasting
  • Greater than 3500 ng/dL
  • Not necessary
Non-classic type
  • Needs for confirmation

Salt-wasting crises in infancy in classic type

References

  1. Speiser PW, White PC (2003). "Congenital adrenal hyperplasia". N. Engl. J. Med. 349 (8): 776–88. doi:10.1056/NEJMra021561. PMID 12930931.
  2. White PC, Speiser PW (2000). "Congenital adrenal hyperplasia due to 21-hydroxylase deficiency". Endocr. Rev. 21 (3): 245–91. doi:10.1210/edrv.21.3.0398. PMID 10857554.