Abstract
Extract: Aldosterone secterion rates(ASR) and exchangeable body sodium (Nae) have been measured simultaneously in 25 cases of congenital adrenal hyperplasia (CAH) with and without salt loss, both during normal and during low salt intake. The degree of 21-hydroxylase deficiency was assessed from the cortisol secretion rate (CSR) and urinary excretion of pregnanetriol and 11-ketopregnanetriol.
In cases with salt loss, the sodium equilibrium was unstable, even with optimum treatment and increased dietary salt intake. Clinical evidence of salt-losing crisis appeared when 15-25% of Nae was lost. In these subjects, a parallel decrease in ASR and CSR usally occurred. The ASR were somewhat elevated in the nonsalt-losing form.
Speculation: A salt-excreting factor is probably present in CAH, even in the nonsalt-losing form, since the ASR is raised, while the Nae remains normal.
Salt loss due to 21-hydroxylase deficiency decreases with age. This appears to be due to modifications in the distribution of body sodium and to an absolute increase in the dietary salt intake rathere than to modifications in adrenal secretion.
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Loras, B., Haour, F. & Bertrand, J. Exchangeable Sodium and Aldosterone Secretion in Children with Congenital Adrenal Hyperplasia due to 21-Hydroxylase Deficiency. Pediatr Res 4, 145–156 (1970). https://doi.org/10.1203/00006450-197003000-00005
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DOI: https://doi.org/10.1203/00006450-197003000-00005
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