152 DIURNAL SALIVARY SIEROIO PATTERNS AS AN INDEX OF ADEQUACY OF TREATMENT IN 21-HYDROXYLASE DEFICIENCY (21-HD) QUANCY OF TREATEMENT IN 21-HYDROXYLASE DEFICIENCY (21-HD)

Abstract

18 prepubertal patients treated for 21-HD collected saliva samples 3 times a day for determination of 17-OH progesterone (17-OHP) and Androstenedione (A-dione) at a total of 43 occasions. Adequacy of therapy at the moment of sampling was designated as undertreated (I:n=13), adequately treated (II:n=15), or probably overtreated (III:n=15) according to the growth velocity. The upper reference limit for both salivary 17-OHP and A-diono was 7 ng/dl. Diurnal variation was defined as the highest value divided by the lowest one on the same day.

Results are presented as median values (ng/dl).:

During undertreatment both steroids were elevated during most of the day. Adequate treatment coincided with high normal A-dione values, but elevated 17-OHP levels, only during a part of the day resulting in a pronounced diurnal variation. Very low A-dione values and only moderately elevated 17-OHP values with much less diurnal variation pointed to overtreatment. It is concluded that diurnal salivary steroid patterns are a reliable index of adequacy of treatment in 21-HD, even for detection of overtreatment.

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