Abstract
The following studies were undertaken to explore in detail the androgenic secretory capabilities of the prepubertal adrenal. Five 6–11-year-old children with active rhcumatic carditis, otherwise non-toxic, were given ACTH gel 2.2–2.9 μ/kg i.m. daily for one week as initial therapy. Plasma C 19 steroids and indices of testosterone binding protein concentration and unbound androgens were determined by competitive protein binding techniques developed in this laboratory.
Mean urinary corcoids rose from a mean (±SD) of 1.1±1.2 to 15.7±4.3 mg/day and 17-KS from 0.84±0.69 to 3.4±0.98 mg/day. Bascline mean plasma concentrations (±SEM) were: testosterone (T) 6.7±2.4 (range 1.6±15.0), androstenedione (Δ) 15.2±4.4 (range 2.7–29.6), and dehydroepiandrosterone (D) 71.6±6.2 (range 39.8–1124) ng%. Following ACTH, these were increased in each: T–22.3±3.9, Δ–149±22, and D–347±95 ng%. D-sulfate rose in each from 13.5±3.2 (range 2.3–19.8) to 62.8±24 μg%. These changes were accompanied by a fall in testosterone binding protein concentration in four. There was a concurrent rise in unbound androgen levels in all subjects as a consequence of ACTH. This steroidogenic pattern is characterized by a disproportionate increase in Δ concentration, the values sometimes exceeding those of the normal adult. Evidence, thus, has been gained that the adrenal cortex of the prepubertal to chronic ACTH administration.
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Rosenfield, R., Grossman, B. & Ozoa, N. The Prepubertal Androgenic Response to ACTH. Pediatr Res 4, 459 (1970). https://doi.org/10.1203/00006450-197009000-00100
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DOI: https://doi.org/10.1203/00006450-197009000-00100