Detection of the metabolites of dehydroepiandrosterone in urine with gas chromatography-combustion-isotope ratio mass spectrometry / 药学学报

<p><b>AIM</b>To establish a method to determine the isotope ratios of 13C to 12C of dehydroepiandrosterone and its metabolites in urine, for detecting the source of dehydroepiandrosterone or its metabolites.</p><p><b>METHODS</b>Preliminary separation of endogenous anabolic androgenic steroids could be achieved using solid phase extraction, enzymolysis and thin layer chromatography. The source of dehydroepiandrosterone and other endogenous anabolic androgenic steroids could be detected by their delta values with gas chromat ography-combustion-isotope ratio mass spectrometry.</p><p><b>RESULTS</b>The 5 values of some metabolites of dehydroepiandrosterone reduced after the administration of dehydroepiandrosterone preparation. In these cases the data indicated that exogenous anabolic androgenic steroids were administrated.</p><p><b>CONCLUSION</b>The source of dehydroepiandrosterone or its metabolites in urine could be detected by measuring their delta values with this method.</p>

Hiperplasia suprarrenal congenita virilizante por deficit de 21 - hidroxilasa: diagnostico precoz y respuesta a dos esquemas de tratamiento. / Virilizing congenital adrenal hyperplasia due to 21 - hydroxylase deficiency: early diagnosis and response to 2 treatment schedules

Se presentan 12 pacientes con hiperplasia suprarrenal congenita virilizante por deficit de 21 hidroxilasa. Se comparan los indices de laboratorio utiles para el diagnostico precoz (< 10 dias de vida) y tardio de esta patologia y se estudia la respuesta a dos esquemas terapeuticos usados en forma consecutiva, iguales en la dosis diaria de cortisol (20-30 mg/m2/dia) pero diferentes en su distribucion horaria en el dia (esquema I: dos dosis iguales a las 08:00 y 16.00 horas; esquema II: 1/4 de la dosis a las 08:00 y 16:00 horas y 1/2 dosis del total a las 23:00 horas). Se evidencio una baja sensibilidad diagnostica para los esteroides urinarios antes de los 4 casos en que se midio y los 17 cetoesteroides en 2 de 5 pacientes. Por el contrario, la 17 OH Progesterona siempre estuvo anormal antes y despues de los 10 dias de vida. Solo el esquema de tres dosis diarias (esquema II) acerco a la normalidad las concentraciones plasmaticas de 17 OH Progesterona (esquema I: 32.1 +/- 9.5 ng/ml vs esquema II: 4.6 +/- 4.1 ng/ ml; p < 0.0001); el potasio serico tambien bajo mas con el esquema II que con el esquema I (esquema I: 5.2 +/- 0.4 mEq/1 vs esquema II: 4.5 +/- 0.6 mE/q1; p < 0.025).El mejor resultado del esquema II sugiere que la redistribucion de las dosis diarias de cortisol puede conseguir un mejor control hormonal y mejorar las expectativas de crecimiento de estos ninos

3 Cases of Congenital Adrenal Hyperplasia

We present 3 cases of congenital hyperplasia. Case lis a 5 year and 9 month old who is suffered from excessive salt craving and symptoms of precocious puberty. Case llis a 2 month old boy who has failure to thrive and frequent episode of dehydration. Case lll is a 5 year and 3 month old girl who has enlarged clitoris without salt craving since birth. All 3 cases have higher level of 17KS than normal but normal blood pressure. Serum 17 OH progesterone or urinary pregnanetriol were not checked. All patients were well responding with corticosteroid and 17 KS in 24 hour urine were decreased to normal. These patients are considered to have 21 hydroxylation defect type in congenital adrenal hyperplasia. Review of literature and references on congenital adrenal hyperplasia was attempted priefly.