The use of plasma androstenedione in monitoringtherapy of patients with congenital adrenal hyperplasia

Therapy of congenital adrenal hyperplasia transidtionally is monitored by the amount of urinary 17-KS. However, 24-hour urine collections are difficult to obtain and are often unreliable. Measurement of the plasma concentrations of androgens, such as Δ or T, would therefore be a more convenient way to determine the efficacy of treatment. Over a period of 2 to 24 months, 23 patients were periodically assessed by clinical examination, bone age, and determinations of plasma Δ, plasma T, and 24-hour urinary 17-KS. Plasma T concentration correlated well with clinical control in females and in preadolescent males, but not in infant and pubertal males. By contrast, plasma Δ concentration correlated well with clinical control in either sex, regardless of stage of puberty. The present study suggests that monitoring plasma Δ concentration is useful in the long-term management of patients with CAH.