+ Resolve Article
+ Follow Us
Follow on FacebookFollow on Facebook
Follow on TwitterFollow on Twitter

+ Translate
+ Subscribe to Site Feed
GeoScience Most Shared ContentMost Shared Content

Failure of cortisone acetate therapy in 21-hydroxylase deficiency in early infancy

, : Failure of cortisone acetate therapy in 21-hydroxylase deficiency in early infancy. Pediatrics International 43(5): 478-482, October

Background: Pediatric endocrinologists initially treat congenital adrenal hyperplasia with either cortisone acetate (CA) or hydrocortisone (HC). Despite high doses of CA, we noted that 17-hydroxyprogesterone (17-OHP) and corticotropin were not fully suppressed in serum from neonates with 21-hydroxylase deficiency (21-OHD) until they were 40- to 80-days-old. In contrast, serum concentrations of 17-OHP were suppressed immediately by oral treatment with HC. Methods: We sought to understand the reason for this discrepancy. Serum cortisol (F), cortisone (E), and 17-OHP were measured by radioimmunoassay or high-performance liquid chromatography in seven neonates with 21-OHD and in 118 normal subjects. From the time of diagnosis, CA was administered to four of the neonates with 21-OHD, while HC was given to the other three. Results: In normal subjects serum E concentrations were greater than F during the first 2 months after birth, whereas F concentrations exceeded E after 2 months of age. Although infants receiving CA initially were given a high dose, serum F concentrations were extremely low, while 17-OHP concentrations were high until about 2 months of age. Then serum F exceeded E, and 17-OHP became fully suppressed even though infants received only a moderate dose of CA. In contrast, HC administration successfully normalized serum 17-OHP in the neonatal period. With temporary switching of neonates from HC to CA, serum F concentrations immediately decreased and 17-OHP concentrations increased. Conclusion: Conversion of E to F may be limited during early infancy, adversely affecting treatment with CA. Cortisone acetate may be inappropriate as a glucocorticoid replacement during early infancy in patients with 21-OHD.


PMID: 11737708

DOI: 10.1046/j.1442-200x.2001.01432.x

Other references

Bergenthal, D.M.ster, I.R.zsa, Z.R.isch, J., 1979: Carbon-13 isotope nuclear magnetic resonance spectra of some acridone alkaloids. Phytochemistry 8(1): 161-163

Anonymous, 2017: "Convenient Untruths": An Unanticipated Opportunity for Science and the Public. Faseb Journal 31(5): 1769-1771

Monti, V.; Lombardo, G.; Loxdale, H.D.; Manicardi, G.Carlo.; Mandrioli, M., 2012: Continuous occurrence of intra-individual chromosome rearrangements in the peach potato aphid, Myzus persicae (Sulzer) (Hemiptera: Aphididae). Analysis of the holocentric mitotic chromosomes of the peach-potato aphid, <i>Myzus persicae</i> (Sulzer), from clones labelled 5, 51 and 7 revealed different chromosome numbers, ranging from 12 to 14, even within each embryo, in contr...

Little H.J.; Paton W.D.M., 1979: Effects of anesthetics and helium pressure on acetyl choline release. British Journal of Anaesthesia 51(1): 62P

Lawler, A., 1995: O'Leary takes swipe at bureaucracy. Science 268(5212): 794-794

Bardi, J.; Marques, A., C., 2007: Redescricao taxonomica da caravela-do-mar, Physalia physalis (Cnidaria, Hydrozoa, Siphonophorae, Cystonectae) do litoral do Brasil. Although Physalia physalis (Linnaeus, 1758) is widely known from the Brazilian waters, specimens from this coast were never properly described. We describe Brazilian specimens of P. physalis including information on morphology, cnidome, SEM, and h...

Adams John; Sharp Jennifer, 1986: New Eastern Canadian focal mechanisms; what happens to the regional stress field below 10 km?. Earthquake Notes 57(4): 106

Wan, L.; Wang, Q.; Deng, J.; Gong, Q.; Yang, L.; Liu, H., 2010: Identification of mineral intensity along drifts in the Dayingezhuang Deposit, Jiaodong gold province, China. Great mineral intensity in drifts or drills is characterized by both the high proportion and spatial cluster of the high grades. Great mineral intensity indicates the high ore quality and low dilution in the exploitation. The fractal dimension, th...

Pesman, M.Walter, 1962: Design for a Colorado naturalistic garden. Plants And Gard 18(1): 64-65

Jelincic, Z.; Jakic-Razumovic, J.; Petrovic, I.; Cavcic, A.Marija.; Unusic, J.; Trotic, R., 2005: Primary malignant melanoma of the stomach. We report a 54-year-old patient with a complaint of weakness, abdominal pain and weight loss. During the clinical examination a palpable tumor resistance in the abdomen was found as well as iron deficiency anemia. Gastroscopy showed an exulcerated...