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Case Reports
. 1999 Nov;81(3):F179-83.
doi: 10.1136/fn.81.3.f179.

Influence of spironolactone on neonatal screening for congenital adrenal hyperplasia

I Terai  1 , K Yamano, N Ichihara, J Arai, K Kobayashi
Affiliations
Case Reports

Influence of spironolactone on neonatal screening for congenital adrenal hyperplasia

I Terai et al. Arch Dis Child Fetal Neonatal Ed. 1999 Nov.

Abstract

Aim: To determine if the diuretic spironolactone cross reacts with 17alpha-hydroxyprogesterone (17OHP) in an enzyme linked immunosorbent assay (ELISA) kit used for the mass screening of congenital adrenal hyperplasia.

Methods: Concentrations of 17OHP on a blood filter paper disc were measured using an ELISA kit (kit C-7: ENZAPLATE N-17alpha -OHP-7; Chiron, Tokyo, Japan). The cross reactivity of spironolactone and its metabolites with 17OHP was determined. The concentrations of spironolactone and its metabolites in blood were measured using HPLC (high performance liquid chromatography).

Results: Spironolactone cross reacted with 17OHP using kit C-7 (0.01%), by increasing 17OHP concentration in a dose dependent manner. The blood concentration of spironolactone and its metabolites was nearly 900 ng/ml, high enough to show an additive effect on the 17OHP concentration. About 12% of the false positive cases screened using the kit were due to the administration of spironolactone.

Conclusions: Spironolactone interferes with 17OHP concentrations, leading to false positive test results for CAH.

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References

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