EFFECT OF CORTISOL TREATMENT ON HORMONAL RELATIONSHIPS IN CONGENITAL ADRENAL HYPERPLASIA

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Abstract
The temporal relationship between administration of cortisol and serum 17.alpha.-hydroxyprogesterone was investigated in 5 patients aged 9-19 yr with congenital adrenal hyperplasia due to 21-hydroxylase deficiency. There was marked variability in the 17.alpha.-hydroxyprogesterone response (determined hourly for 24 h) of individual patients to administration of cortisol. Mean concentration was less than 0.030 .mu.mol/l in 1 patient but 0.519 .mu.mol/l in another. Levels were higher in all patients while off treatment, and were greatest in those with salt-losing adrenal hyperplasia. Growth hormone secretion was not suppressed by treatment with cortisol. Withdrawal of cortisol for 3 days resulted in a significant decrease in the mean serum FSH[follicle stimulating hormone]/LH [luteinizing hormone] ratio and a rise in serum testosterone in all subjects. Episodic release of gonadotropins persisted in the adolescent patients.