Asset Details
Do you wish to reserve the book?
Free Cortisol and Free 21-Deoxycortisol in the Clinical Evaluation of Congenital Adrenal Hyperplasia
Hey, we have placed the reservation for you!
By the way, why not check out events that you can attend while you pick your title.
Oops! Something went wrong.
Looks like we were not able to place the reservation. Kindly try again later.
Are you sure you want to remove the book from the shelf?
Free Cortisol and Free 21-Deoxycortisol in the Clinical Evaluation of Congenital Adrenal Hyperplasia
Do you wish to request the book?
Free Cortisol and Free 21-Deoxycortisol in the Clinical Evaluation of Congenital Adrenal Hyperplasia
Please be aware that the book you have requested cannot be checked out. If you would like to checkout this book, you can reserve another copy
We have requested the book for you!
Your request is successful and it will be processed during the Library working hours. Please check the status of your request in My Requests.
Oops! Something went wrong.
Looks like we were not able to place your request. Kindly try again later.
Journal Article
Free Cortisol and Free 21-Deoxycortisol in the Clinical Evaluation of Congenital Adrenal Hyperplasia
2025
Overview
Some patients with classic congenital adrenal hyperplasia (CAH) survive without glucocorticoid treatment. Increased precursor concentrations in these patients might lead to higher free (biological active) cortisol concentrations by influencing cortisol-protein binding. In 21-hydroxylase deficiency (21OHD), the most common CAH form, accumulated 21-deoxycortisol (21DF) may further increase glucocorticoid activity. Both mechanisms could explain the low occurrence of symptoms in some patients with untreated classic CAH.
Develop and validate a liquid chromatography tandem mass spectrometry (LC-MS/MS) method for free cortisol and free 21DF to quantify these steroids in patients with untreated classic CAH before and after Synacthen administration, and compare these concentrations to concentrations measured in patients with nonclassic CAH (NCCAH), other forms of adrenal insufficiency (AI), and controls.
An LC-MS/MS method to measure free cortisol and free 21DF was developed and validated. Total and free serum concentrations of both cortisol and 21DF were measured in patients with untreated classic CAH (n = 29), NCCAH (n = 5), AI (n = 3), and controls (n = 11) before and 60 minutes after stimulation with Synacthen.
Unstimulated total cortisol concentrations of patients with untreated classic CAH (median 109 nmol/L) were lower than in patients with untreated NCCAH (249 nmol/L, P = .010) and controls (202 nmol/L, P = .016), but free cortisol concentrations were similar. Basal free 21DF concentrations were high in patients with 21OHD (median 5.32 nmol/L) and undetectable in patients with AI and controls (<0.19 nmol/L). After Synacthen administration, free 21DF concentrations increased in patients with 21OHD, while free cortisol concentrations did not change.
Free cortisol concentrations in patients with classic CAH were similar to those in controls and patients with NCCAH, indicating comparable cortisol availability. Additionally, patients with 21OHD produce high concentrations of 21DF, possibly explaining the low occurrence of symptoms in some patients with classic 21OHD. Free cortisol and 21DF levels should be considered in evaluating adrenal insufficiency in patients with CAH.
Publisher
Oxford University Press
Subject
/ Adrenal Hyperplasia, Congenital - blood
/ Adrenal Hyperplasia, Congenital - diagnosis
/ Adrenal Hyperplasia, Congenital - drug therapy
/ Adrenal Insufficiency - blood
/ Adrenal Insufficiency - diagnosis
/ Adult
/ Child
/ Chromatography, Liquid - methods
/ Clinical
/ Cortisol
/ Female
/ Hormones
/ Humans
/ Male
/ Patients
