CAH Panel 3 Aldosterone Synthase Deficiency
- Laboratory
- Quest Diagnostics
- Test code
- 15273
- Specimen
- Serum
- Fasting
- Not stated as required
What the laboratory says this test is for
This panel may be used for differential diagnosis of congenital adrenal hyperplasia (CAH) and aldosterone synthase deficiency. In addition to the analytes included in this panel (17-hydroxyprogesterone, 11-deoxycortisol, 18-hydroxycorticosterone, aldosterone), other tests may be required to establish a diagnosis.CAH is a group of autosomal recessive diseases characterized by deficiencies of enzymes in steroid hormone production. These deficiencies cause imbalances of steroid intermediates and hormones. Clinical manifestations of CAH vary and depend upon the type of defect [1,2]. When symptoms and signs suggest aldosterone deficiency, this panel may be used to assist in diagnosing different types of CAH as well as aldosterone synthase deficiency, an inherited disorder caused by disruption of the final steps of aldosterone biosynthesis [3].17-hydroxyprogesterone levels are elevated in patients with 21-hydroxylase deficiency (the cause of 95% of CAH). 11-beta-hydroxylase and P450 oxidoreductase deficiency can also result in elevated 17-hydroxyprogesterone levels, whereas other types of CAH can result in decreased 17-hydroxyprogesterone levels [1,2].11-deoxycortisol levels are elevated in patients with 11-beta-hydroxylase deficiency and decreased in patients with P450 cholesterol side-chain cleavage enzyme deficiency [2].18-hydroxycorticosterone is markedly elevated in patients with corticosterone methyloxidase (CMO) deficiency type II and mildly decreased in patients with CMO deficiency type I [3].Aldosterone levels are decreased in patients with most types of CAH and CMO deficiency type II and undetectable in patients with CMO deficiency type I [3].Other tests and panels are available to help differentiate among different types of CAH and disorders with similar clinical manifestations.The results of this test should be interpreted in the context of pertinent clinical and family history and physical examination findings.References1. Speiser PW, et al. J Clin Endocrinol Metab. 2018;103(11):4043-4088.2. El-Maouche D, et al. Lancet. 2017;390(10108):2194-22103. White PC. Mol Cell Endocrinol. 2004;217(1-2):81-87.
Quest Diagnostics test directory, test code 15273