17-ALPHA-HYDROXYPROGESTERONE

Code
900.0025
Name
17-ALPHA-HYDROXYPROGESTERONE
Category
None
Department
Send-Out
Start Date
02/27/2012
Expiration Date
Synonyms
Hydroxyprogesterone; 17-OHP; 17a-OH Progesterone
CPT Codes
83498
Site
SBMF
Reference Test
44203
ATLAS Test Code

Specimen Information

Type

Gold top (SST), Red top (serum), Lavender top (EDTA), or Green top (heparin) tube

Volume

0.5 mL

Transport Info

Centrifuge and immediately transfer serum or plasma to separate plastic tube
Frozen

Fasting Required?
False
Patient Instructions

Patient must not have received isotopes during 24 hours period prior to sample collection.

Reference Range


Premature (26-28 weeks)...Female:..124-841 ng/dL....Male:..124-841 ng/dL
Premature (29-35 weeks)...Female:...26-568 ng/dL.....Male:..26-568 ng/dL
Full term Day 3..................Female:....7-77 ng/dL........Male:..7-77 ng/dL
4 days-30 days..................Female:....7-106 ng/dL
4 days-2 months ......................................................Male:Less than 200 ng/dL
1-5 months........................Female:...13-106 ng/dL
3-5 months...............................................................Male:..3-90 ng/dL
6 months-1 year...Female:Less than or equal to 148 ng/dL...Male:Less than or equal to 148 ng/dL
2-3 years..............Female:Less than or equal to 256 ng/dL...Male:Less than or equal to 228 ng/dL
4-6 years..............Female:Less than or equal to 299 ng/dL...Male:Less than or equal to 208 ng/dL
7-9 years..............Female:Less than or equal to 71 ng/dL.....Male:Less than or equal to 63 ng/dL
10-12 years...........Female:Less than or equal to 129 ng/dL...Male:Less than or equal to 79 ng/dL
13-15 years...........Female:..9-208 ng/dL.............................Male:9-140 ng/dL
16-17 years...........Female:Less than or equal to 178 ng/dL...Male:24-192 ng/dL
18 years and older.Female:Less than 207 ng/dL....................Male:Less than 139 ng/dL
Follicular................Female:..15-70 ng/dL
Luteal....................Female:..35-290 ng/dL
Tanner Stage I:......Female:Less than or equal to 74 ng/dL.....Male:Less than or equal to 62 ng/dL
Tanner Stage II......Female:Less than or equal to 164 ng/dL...Male:Less than or equal to 104 ng/dL
Tanner Stage III.....Female:..13-209 ng/dL...........................Male:Less than or equal to 151 ng/dL
Tanner Stage IV-V..Female:....7-170 ng/dL...........................Male:20-173 ng/dL

Methodology

Quantitative High Performance Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS)

Clinical Significance

17-OHP serum levels are primarily useful in the diagnosis of congenital adrenal hyperplasia (CAH) due to deficiency of 21-hydroxylase or 11 ß-hydroxylase. The assay has also been used to help identify the heterozygous state of 21- hydroxylase deficiency by testing before, and 30 and 60 minutes after, ACTH stimulation.

17-hydroxyprogesterone (17-OHP, 4-pregren-17-ol-3, 20-dione) is a twenty-one-carbon steroid produced in the adrenals, gonads, and placenta. It is the metabolic product of progesterone and 17-hydroxypregnenolone and is a precursor to cortisol. A synthetic defect in 21-hydroxylase results in diminished cortisol synthesis, elevated ACTH, accumulation of 17-hydroxyprogesterone (particularly after the administration of ACTH), possible virilization due to increased adrenal androgen production, and possible salt wasting due to diminished production of aldosterone and deoxycorticosterone. 17-OHP serum levels exhibit a diurnal pattern similar to cortisol, and increase during the luteal phase of the menstrual cycle and during pregnancy. In the most common form of congenital adrenal hyperplasia, deficiency of the enzyme 21-hydroxylase blocks normal synthesis of cortisol, leading to a compensatory increase of ACTH secretion. This results in adrenal hyperplasia with increased levels of 17a-hydroxyprogesterone, DHEA and other adrenal steroids.

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