Genotyping steroid 21-hydroxylase deficiency: Hormonal reference data

Maria I. New, Franziska Lorenzen, Alan J. Lerner, Brenda Kohn, Sharon E. Oberfield, Marilyn S. Pollack, Bo Dupont, Elizabeth Stoner, Donna J. Levy, Songya Pang, Lenore S. Levine

Research output: Contribution to journalArticlepeer-review

529 Scopus citations


Hormonal reference data, in the form of nomograms relating baseline and stimulated levels of adrenal hormones, provide a means of genotyping steroid 21-hydroxylase (21-OH) deficiency in congenital adrenal hyperplasia. Data from both 360- and 60-min ACTH stimulation tests are given. The serum hormone concentrations that have proven most useful in classifying 21-OH deficiency are 17-hydroxyprogesterone and Δ4-androstenedione. These nomograms clearly distinguish the patient with classical 21-OH deficiency from those with the milder symptomatic and asymptomatic nonclassical forms of 21-OH deficiency (previously referred to as late onset and cryptic forms) as well as heterozygotes for all of the forms and those subjects predicted by HLA genotyping to be unaffected. The nomograms also can identify individuals heterozygous for 21-OH deficiency in the general population who have a characteristic heterozygote response. These nomograms provide a powerful tool by which to assign the 21-OH deficiency genotype. Patients whose hormonal values fall on the regression line within a defined group are assigned to that group. In view of the strong correlation between the 60- and 360-min ACTH stimulation tests, the less cumbersome and shorter 60-min test can be used with the same confidence as the longer test.

Original languageEnglish (US)
Pages (from-to)320-326
Number of pages7
JournalJournal of Clinical Endocrinology and Metabolism
Issue number2
StatePublished - Aug 1983
Externally publishedYes

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Biochemistry
  • Endocrinology
  • Clinical Biochemistry
  • Biochemistry, medical


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