Adrenal steroids synthesis during acute infectious diseases in infants

Date
2002-11-01Author
Longui, C. A.
Zlochevsky, ERM
Bachega, Tania Aparecida Sartori Sanchez [UNIFESP]
Monte, O.
Type
ArtigoISSN
0334-018XIs part of
Journal Of Pediatric Endocrinology & MetabolismDOI
10.1515/JPEM.2002.15.9.1515Metadata
Show full item recordAbstract
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.
Citation
Journal Of Pediatric Endocrinology & Metabolism. London: Freund Publishing House Ltd, v. 15, n. 9, p. 1515-1523, 2002.Keywords
adrenal glandadrenal steroids
cortisol
17-hydroxyprogesterone
acute infectious diseases
critical care patients
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