Abstract
The regulatory mechanisms of adrenarche and PA, including the existence of a non-ACTH androgen stimulating factor, are controversial. We sought to evaluate the suppressibility of the HPA axis in PA in 24 children (age 1.5-8.75 yrs, 4M/20F) in whom the dx of PA was confirmed by ACTH testing. We measured cortisol and androgen at SAM after a single PH low dose of DEX 0.3mg/m2 given between 11PM-MN (Hindmarsh and Brook, Clin Endo 1985.) 2 Groups of PA were defined by their response to DEX. GROUP I:(n=12) cortisol(F) <5ug/dl, GROUP II:(n=12)F ≥ 5ug/dl (p=.01)
The mean age was 88 vs 84 months for I vs II and the mean CA/BA was 1.2 vs 0.99, I vs II. Although the mean responses to ACTH and DEX of T, DHEA, δ4A, 17OHP and A517P did not differ, the rate of increase response to ACTH and decrease to DEX of Δ517P, DHEA and Δ4A were sig. greater in group I vs group 11.(*=p<.002) These results suggest a greater sensitivity to changes in ACTH secretion in I vs II These indings further suggest the possibility of different regulatory mechanisms resulting in PA: an ACTH and a non-ACTH factor.
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Oberfield, S., Amer, T., Tyson, D. et al. ALTERED SENSITIVITY TO LOW DOSE DEX IN A SUBSET OF PATIENTS WITH PREMATURE ADRENARCHE (PA). Pediatr Res 33 (Suppl 5), S18 (1993). https://doi.org/10.1203/00006450-199305001-00092
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DOI: https://doi.org/10.1203/00006450-199305001-00092
