Abstract
Serum levels of DHEAS and 17-hydroxyprogesterone (17OHP) were measured in 20 females (2.5-22 yrs) and 11 males (2.5-16.5 yrs) with CAH due to 21-hydroxylase deficiency treated with oral hydrocortisone (HC) (non-salt losers, n=12), or HC and Florinef (salt losers, n=19). Adequacy of therapy was judged by clinical findings, growth rate, bone age, serum 17OHP, urinary 17 ketosteroids and pregnanetriol. These allowed separation of patients into 3 groups: A- poor control (n=11), B- good control (n=12), and C-mildly overtreated (n=8). The groups were comparable for sex ratio but mean age in group C (5.5±1.9 yrs) was lower than group A (13.7±2.1 yrs) or group B (11.4±6 yrs). In "optimally" treated patients (group B), whose serum levels of 17 OHP were consistent with adequate treatment (250±189 ng/dl), mean serum level of DHEAS was significantly lower than that in age matched controls (23±20 vs 82±42 μg/dl, P <0.01). Serum levels of DHEAS in group C were all below the sensitivity of the assay (<5 μg/dl). Serum levels of 17OHP were also suppressed in this group (12±5 ng/dl). In poorly controlled patients (group A), mean serum level of DHEAS was slightly but not significantly higher than controls (121±80 vs 92±39 μg/dl) while serum 17OHP levels were abnormally high (>1000 ng/dl). These data indicate that doses of HC necessary for "optimal" treatment of CAH result in oversuppression of serum levels of DHEAS. This supports the hypothesis that the secretion of DHEAS may be controlled by a hormone other than ACTH.
Article PDF
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Garibaldi, L., Rezvani, I., Artman, H. et al. Excessive suppression of serum dehydroepiandrosterone sulfate (DHEAS) in patients treated for congenital adrenal hyperplasia (CAH): 63. Pediatr Res 14, 175 (1980). https://doi.org/10.1203/00006450-198002000-00090
Issue Date:
DOI: https://doi.org/10.1203/00006450-198002000-00090