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Title: Adrenal steroids synthesis during acute infectious diseases in infants
Authors: Longui, C. A.
Zlochevsky, ERM
Bachega, Tania Aparecida Sartori Sanchez [UNIFESP]
Monte, O.
Universidade Federal de São Paulo (UNIFESP)
Universidade de São Paulo (USP)
Keywords: adrenal gland
adrenal steroids
acute infectious diseases
critical care patients
Issue Date: 1-Nov-2002
Publisher: Freund Publishing House Ltd
Citation: Journal Of Pediatric Endocrinology & Metabolism. London: Freund Publishing House Ltd, v. 15, n. 9, p. 1515-1523, 2002.
Abstract: An increase in plasma 17OHP found in infants requiring differential diagnosis between septic shock and adrenal failure led us to look for adrenal steroids pattern during infection. Infants and Methods: 56 infants, 1-6 months old, were studied during infection of different degrees of severity. Plasma cortisol, 17OHP, androstenedione, DHEA, DHEA-S and testosterone were measured.Results: 24 patients showed an expected cortisol elevation. One child had a low cortisol level. The concentration of 17OHP was above 6.0 nmol/l (200 ng/dl) in 41 patients and above 30.2 nmol/l (1,000 ng/dl) in 10. Higher 17OHP levels and more severe diseases correlated positively.Conclusions: During infectious diseases some patients demonstrated not only cortisol elevation but also 17OHP as high as that observed in NC-CAH. We suggest that if 17OHP elevation is not characteristic of SL-CAH, glucocorticoid therapy should be started and an ACTH test should be performed after recovery before ruling out this pathology.
ISSN: 0334-018X
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