Abstract
A neonatal screening for both 21-hydroxylase and 11-β-hydroxylase deficiencies, responsible for congenital adrenal hyperplasia (CAH), has been conducted in Campania Region, Southern Italy. In 4380 neonates, aged 2–10 days, capillary blood from a heel prick was collected on microfilter paper, and 17-α-hydroxyprogesterone (17OHP) measured by radioimmunoassay (RIA) using a highly specific antibody (Ab A). In addition, in 295 of these samples, both 17OHP and 11-deoxycortisol (S) were measured using an anti-deoxycortisol antibody (Ab B) cross-reacting with 17OHP 100%. All results were compared with plasma 17OHP and S levels in 21 patients with diagnosed 21-hydroxylase deficiency and in 5 healthy volunteers on metyrapone test used for blocking the 11-β-hydroxylase activity. CAH due to 21-hydroxylase deficiency was diagnosed in a female newborn. The assay, based on the antibody reacting with both 17OHP and S, is particularly suitable for wide-scale screening programs enabling the simultaneous detection of two congenital enzyme defects.
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Lombardi G., Oliver C., Lupoli G., Minozzi M., Corticotrophic and melanotrophic function in congenital adrenal hyperplasia. Acta Endocrinol. (Copenh.) 85: 118, 1977.
Pang S.Y., Wallace M.A., Hofman L., Thuline H.C., Dorche C., Lyon I.C., Dobbins R.H., Kling S., Fujieda K., Suwa S. Worldwide experience in newborn screening for classical congenital adrenal hyperplasia due to 21-hydroxylase deficiency. Pediatrics 81: 866, 1988.
White C.P., New M.I., Dupont B. Congenital adrenal hyperplasia. N. Engl. J., Med. 316: 1519, 1987.
Thompson R., Seargeant L., Winter J.S. Screening for congenital adrenal hyperplasia: Distribution of 17-alpha-hydroxyprogesterone concentrations in neonatal blood spot specimens. J. Pediatr. 114: 400, 1989.
Cacciari E., Balsamo A., Cassio A., Piazzi S., Bernardi F., Salardi S., Cicognani A., Pirazzoli P., Zappulla F., Cappelli M., Paolini M. Neonatal screening for congenital adrenal hyperplasia. Arch. Dis. Child. 58: 803, 1983.
Honda M., Nowaczynski W., Guthrie G.P., Nesserli F.H., Tolis G., Kuchel O., Genest J. Response of several adrenal steroids to ACTH stimulation in essential hypertension. J. Clin. Endocrinol. Metab. 44: 264, 1977.
De Simone G., Tommaselli A.P., Rossi R., Valentino R., Lauria R., Scopacasa F., Lombardi G. Partial deficiency of adrenal 11-β-hydroxylase. A possible cause of primary hypertension. Hypertension 7: 204, 1985.
Pang S., Hotchkiss J., Drash A.L., Levine L.S., New M.I. Microfilter paper method for 17-α-hydroxy-progesterone radioimmunoassay: its application for rapid screening for congenital adrenal hyperplasia. J., Clin. Endocrinol. Metab. 45: 1003, 1977.
Solyom J. Blood-spot 17-α-hydroxyprogesterone radioimmunoassay in the follow-up of congenital adrenal hyperplasia. Clin. Endocrinol. (Oxf.) 14: 547, 1981.
Valentino R., Lombardi G., Tommaselli A.P., Rossi R., Scopacasa F., Fariello C., Di Gennaro C., Minozzi M. Neonatal screening of congenital adrenal hyperplasia due to deficit of 21-hydroxylase and/or 11-β-hydroxylase: use of an anti-11-deoxycortisol antibody. J. Endocrinol Invest 6 (Suppl. 1): 89, 1983.
Newsome H.H., Clements A.S., Borum E.H. The simultaneous assay of Cortisol, corticosterone, 11-deoxycortisol and cortisone in human plasma. J. Clin. Endocrinol. Metab. 34: 473, 1972.
Pang S., Pollack M.S., Loo M., Green O., Nussbaum R., Clayton G., Dupont B., New M.I. Pitfalls of prenatal diagnosis of 21-hydroxylase deficiency congenital adrenal hyperplasia. J. Clin. Endocrinol. Metab. 61: 89, 1985.
Scrocca A., Valentino R., Sposato G., Tommaselli A.P., Lombardi G. Correzione chirurgica delle anomalie dei genitali nello pseudoermafroditismo femminile da iperplasia surrenale congenita. Riv. Ital. Chir. Plast. 12: 1, 1980.
Abraham G.E., Manlimos F.S., Garza R. Radioimmunoassay of steroids. In: Jaffe B.M., Behrman H.R. (Eds.), Handbook of radioimmunoassay. Academic Press, New York, 1977, p. 590.
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Valentino, R., Tommaselli, A.P., Rossi, R. et al. A pilot study for neonatal screening of congenital adrenal hyperplasia due to 21-hydroxylase and 11-β-hydroxylase deficiency in Campania region. J Endocrinol Invest 13, 221–225 (1990). https://doi.org/10.1007/BF03349544
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DOI: https://doi.org/10.1007/BF03349544