17α-Hydroxyprogesterone

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Subject: 17α-Hydroxyprogesterone

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Definition

  • 17α-Hydroxyprogesterone, also known as hydroxyprogesterone, is a 21-carbon steroid produced in the adrenals—and also in the ovaries, testes, and placenta—that serves as a biosynthetic precursor to cortisol.

  • Normal range: 18–469 ng/dL (see Table 16.1).

 
TABLE 16–1
Range of Normal Values for 17a-Hydroxyprogesterone

Use

  • Diagnosis and management of congenital adrenal hyperplasia, hirsutism, and infertility

Interpretation

Increased In

  • The luteal phase of menstruating women and pregnancy, during which it rises.

  • When defective 21-alpha hydroxylase and 11-beta hydroxylase are present.

  • The most common form of CAH, where deficiency of the enzyme 21-hydroxylase blocks normal synthesis of cortisol, leading to a compensatory increase of ACTH secretion; this results in increased levels.

Limitations

  • Circulating normally exhibits a diurnal pattern similar to that of cortisol, with higher values in the early morning than in the late afternoon. Hence, the time of collection should be standardized.

  • Spuriously elevated levels are sometimes seen in premature and sick newborns due to interference with other steroid metabolites. 17α-Hydroxypregnenolone sulfate (percent cross-reactivity: 3.8%) has been identified as the most significant interferent in direct assays.

  • 17α-Hydroxyprogesterone values for women with late-onset CAH have been found to overlap with those encountered in hirsute, oligomenorrheic women who do not have the disorder. Accordingly, it is important to determine ACTH-stimulated 17α-hydroxyprogesterone levels in women suspected of having late-onset CAH.

 
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