17-Hydroxyprogesterone, Serum

Casandra

Casandra Test Code MC45731Version 1 (DRAFT)

Performing Lab

Lab Mayo Clinic LabLab Test ID OHPGCPT Code 83498

17-Hydroxyprogesterone, Serum

Clinical Use

Use

This test is useful as a screening test for congenital adrenal hyperplasia (CAH), which is caused by either 11- or 21-hydroxylase deficiency when used in combination with cortisol and androstenedione testing. It is also part of a battery of tests to evaluate women with hirsutism or infertility. CAH is due to inherited defects in steroid biosynthesis, with resulting hormone imbalances leading to elevated 17-hydroxyprogesterone and androgens, which can cause life-threatening salt-wasting crisis in newborns and incorrect gender assignment in virilized females.

Special Instructions

The test is performed using the preferred screening method for congenital adrenal hyperplasia caused by 21-hydroxylase deficiency, allowing simultaneous determination of 17-hydroxyprogesterone, androstenedione, and cortisol. Patient's age and sex are required for ordering.

Limitations

At birth, elevated adrenal and sex steroid levels are common due to the activation of hypothalamic-pituitary-adrenal and gonadal axes, with the increased levels being more pronounced in preterm infants due to illness and stress. Therefore, preterm infants may have elevated 17-hydroxyprogesterone levels up to 1000 ng/dL. Diagnosis of CAH can be confused due to these elevated levels in preterm infants. This test does not correlate well with androgen levels, so measurements of androstenedione and testosterone should also be used to guide treatment.

Test Details

New York Approved