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Hormonal disturbances due to severe and mild forms of congenital adrenal hyperplasia are already detectable in neonatal life.
[congenital adrenal hyperplasia]
National
screening
programmes
for
congenital
adrenal
hyperplasia
now
include
measuring
several
adrenal
metabolites
using
highly
sensitive
liquid
chromatography-tandem
mass
spectrometry
.
The
aim
of
this
study
was
to
compare
neonatal
hormonal
profiles
-
whole
blood
concentrations
of
17
α-hydroxyprogesterone
,
androstenedione
,
and
cortisol
-
with
genotypes
in
21
-
hydroxylase
deficiency
.
The
study
included
62
patients
with
congenital
adrenal
hyperplasia
born
between
1982
and
2012
and
61
random
controls
born
in
1985
and
2005
.
Patients
were
grouped
according
to
mutation
-based
predictions
of
enzyme
impairment
.
Groups
Null
and
A
were
salt-wasting
(
n
Â
=
Â
35
)
,
Group
B
was
simple
virilising
(
n
Â
=
Â
7
)
and
Group
C
was
nonclassic
(
n
Â
=
Â
20
)
.
Dried
blood
spot
samples
were
retrieved
from
the
Danish
Neonatal
Screening
Biobank
.
All
patients
with
molecular
verified
21
-
hydroxylase
deficiency
had
significantly
higher
concentrations
of
17
α-hydroxyprogesterone
(
p
Â
<
Â
0
.
001
)
,
androstenedione
(
p
Â
<
Â
0
.
001
)
and
a
higher
ratio
[
(
17
α-hydroxyprogesterone
Â
+
Â
androstenedione
)
/
cortisol
,
p
Â
<
Â
0
.
05
]
than
controls
.
Androstenedione
showed
a
higher
sensitivity
(
72
%
)
than
17
α-hydroxyprogesterone
(
12
%
)
to
correctly
identify
Groups
B
and
C
.
There
were
significant
differences
in
neonatal
hormonal
profiles
between
all
groups
and
controls
.
This
confirms
that
hormonal
disturbances
are
already
detectable
in
both
severe
and
mild
forms
of
congenital
adrenal
hyperplasia
in
neonatal
life
.
Diseases
Validation
Diseases presenting
"controls"
symptom
adrenomyeloneuropathy
congenital adrenal hyperplasia
fabry disease
hereditary cerebral hemorrhage with amyloidosis
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