Abstract
We previously found in CAH patients high 8 am PA and 170H-P with normal PRA levels. This discrepancy was further investigated. 1) 17 salt and non salt-losers, aged 5-17 yrs, treated with F alone, were tested. In 6 of 17, high 8 am supine PA and 170H-P were found with normal PRA levels. However, when re-tested at 11 am while standing, they all had increased PRA and PA values. 2) Six children had repeated hormonal determinations during a 24-h period. In 3 patients, PA and 170H-P decreased in the evening, but PRA remained elevated, while the contrary was observed in the early morning. In the 3 others, PA and PRA were low without PA fluctuations. These results indicate that 1) in CAH patients, PA is modulated by ACTH as in normals. 2) 8 am recumbent PRA is not a good index for the mineralocorticoid adjustment which is better based on PRA measured in standing patients.
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Limal, J., Rappaport, R. Control of plasma aldosterone (PA) in congenital adrenal hyperplasia, 21-hydroxylase defect (CAH). Pediatr Res 12, 1102 (1978). https://doi.org/10.1203/00006450-197811000-00124
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DOI: https://doi.org/10.1203/00006450-197811000-00124