17-Hydroxyprogesterone, Urine 

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17-Hydroxyprogesterone, Urine 

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The reference range of urinary 17-hydroxyprogesterone (17-OHPG) in children is as follows: [1, 2, 3]

Age 3 days to 1 year: Up to 50 ng/24 hours

Age 1-8 years: Up to 300 ng/24 hours

The following is the reference of urinary 17-OHPG in adults:

Males: Up to 2 µg/24 hours

Females: Up to 4.5 µg/24 hours

Elevated urinary 17-hydroxyprogesterone (17-OHPG) levels are associated with the following:

Congenital adrenal hyperplasia (CAH)

Polycystic ovarian syndrome (PCOS)

Specifics for collection and panels are as follows:

Specimen type: Urine

Collection method: 24-hour urine collection (see image below)

Specimen volume: 10 mL

Other instructions: Record duration and total volume

An elevated level of 17-OHPG, an intermediate in the synthesis of adrenocortical hormones, is the distinguishing characteristic of 21-hydroxylase (CYP21) deficiency, the most common form of CAH.

Urine 17-OHPG is also frequently elevated in patients with PCOS or idiopathic hirsutism.

CAH is a general term for a group of inherited disorders in which a defect in cortisol biosynthesis results in overproduction of adrenocorticotropin hormone (ACTH), with secondary adrenal hyperplasia as a consequence. Classic CAH is generally recognized at birth or in early childhood because of ambiguous genitalia, salt wasting, or early virilization. Nonclassic adrenal hyperplasia is generally recognized at or after puberty because of oligomenorrhea or virilizing signs in females.

Indications for testing of urinary 17-OHPG include the following:

In a male child with premature sexual development

In females with hirsutism, other signs of virilization, oligomenorrhea, or infertility

Patients should avoid use of corticosteroids, ACTH, estrogen, or gonadotropin medication for at least 48 hours before the start of urine collection.

Burris CA, Ashwood ER, Burns DE. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. 4th ed. St. Louis: Elsevier Saunders; 2006.

McPherson RA, Pincus MR. Henry’s Clinical Diagnosis and Management by Laboratory Methods. 22nd ed. Philadelphia: Elsevier Saunders; 2011.

Wallach J. Interpretation of Diagnostic Tests. 6th ed. New York: Little, Brown; 1996.

Muhammad Bader Hammami, MD Fellow in Inflammatory Bowel Disease, St Louis University School of Medicine

Disclosure: Nothing to disclose.

Thomas M Wheeler, MD Chairman, Department of Pathology and Immunology, WL Moody, Jr, Professor of Pathology, Professor of Urology, Baylor College of Medicine

Thomas M Wheeler, MD is a member of the following medical societies: Alpha Omega Alpha, American Association for Cancer Research, American Medical Association, American Society for Clinical Pathology, American Society of Cytopathology, American Thyroid Association, American Urological Association, College of American Pathologists, United States and Canadian Academy of Pathology, International Society of Urological Pathology, Harris County Medical Society

Disclosure: Received stock from PathXL for medical advisory board. for: PathXL, Inc.

Judy Lin, MD

Disclosure: Nothing to disclose.

17-Hydroxyprogesterone, Urine 

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