[Salivary 17-hydroxyprogesterone concentration in monitoring of the treatment of congenital adrenal hyperplasia]

Abstract

The salivary concentration of 17-hydroxyprogesterone (17-OHP) was determined in 11 patients (aged 6 months to 13 years) with congenital adrenogenital syndrome (AGS) due to C21-hydroxylase deficiency and six healthy controls, in order to assess its value in monitoring treatment of AGS. Salivary 17-OHP was measured by a specific radioimmunoassay after extraction with dichloromethane. Only 100 microliters of saliva was needed for the assay. There was a good correlation (r = 0.93; P less than 0.01) between 17-OHP concentrations in paired saliva and serum samples from the patients and the control subjects. There was a wide scatter in salivary 17-OHP levels in the range between 164 ng/l (1.7 ng/ml in serum) of satisfactorily or overtreated patients and 15,500 ng/l (247 ng/l in serum) of undertreated patients. Levels in normal children were between 200 and 300 ng/l. It is concluded that treatment of congenital AGS (21-hydroxylase deficiency) can be carefully monitored in children with the noninvasive, frequently repeatable measurement of salivary 17-OHP.