Congenital adrenal hyperplasia in north-east of Iran: a review of 47 patients and the role parental consanguinity in the occurrence of disease.

In this study the clinical and epidemiological characteristics of congenital adrenal hyperplasia were evaluated prospectively in 47 patients admitted in Imam Reza Hospital in Mashhad during a 4 year period. 21-hydroxylase deficiency was present in 42 patients [89.3%], the simple virilizing form in 6 and the salt-losing form in 36 of them. 11b-hydroxylase deficiency was present in 5 patients [10.7%]. The median chronological age at diagnosis in the salt-losing form was 68 and 47 days in boys and girls respectively. 7 girls were considered to be male before the diagnosis was established. Parental consanguinity rate among families of patients was higher than the general population in Mashhad [82% vs. 35%]. In 16.2% of patients the history of disease was positive in siblings. This study showed that the incidence of congenital adrenal hyperplasia is expected to be high due to a high rate of consanguinity in our population, hence genetic counseling before marriage would definitely be beneficial in our population

value of dipstick analysis of urinary protein in pregnancy induced hypertension

In order to determine the value of dipstick analysis of urinary protein in pregnancy induced hypertension, a prospective study analyzing pregnant patients with a diagnosis of hypertensive disorder was conducted to compare the result of urinary protein dipstick analysis with 24hr. urine protein collection in obstetrical clinics affiliated to Shiraz University of Medical Sciences. All patients fulfilling the criteria of the American College of Obstetricians and Gynecologists' definitions for establishing a diagnosis of hypertensive disorder on the basis of urinary dipstick measurements were included in the study. During the study, 102 hypertensive pregnant patients aged from 16-42 years were included in the study. Obtained results showed that the presence of negative value on urinary dipstick with a sensitivity of 100% is a useful method for ruling out significant proteinuria [> 300 mg/24hr]. But values of >2+ are not adequate to confirm a diagnosis of severe hypertensive disorder because its positive predictive value is only 22% and values of > trace-although highly suggestive of significant proteinuria [positive predictive value: 78%]-have a false positive rate of 23%; a timed collection of urine for determination of 24-hr protein excretion becomes mandatory in such cases. The urinary dipstick determination of protein excretion therefore has significant limitations for determination of the presence or severity of proteinuria