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17-Hydroxyprogesterone, Urine
Author: Muhammad Bader Hammami, MD; Chief Editor: Daniela Hermelin, MD more...
Sections 17-Hydroxyprogesterone, Urine
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)
Specifics for collection and panels are as follows:
Specimen type: Urine
Collection method: 24-hour urine collection (see image below)
Urine sample.
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
A study by Itonaga et al indicated that the first morning value of pregnanetriol, a urinary metabolite of 17-hydroxyprogesterone, can be used in place of serum/blood 17-hydroxyprogesterone to monitor 21-hydroxylase deficiency, the most common type of CAH. The investigators found that, prior to glucocorticoid administration, a significant positive correlation exists between the first urinary pregnanetriol measurement and that of blood 17-hydroxyprogesterone. [4]
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.
Itonaga T, Izawa M, Hamajima T, Hasegawa Y. First Morning Pregnanetriol and 17-Hydroxyprogesterone Correlated Significantly in 21-Hydroxylase Deficiency. Front Endocrinol (Lausanne). 2021. 12:808254. [QxMD MEDLINE Link]. [Full Text].
Muhammad Bader Hammami, MD Fellow in Inflammatory Bowel Disease, St Louis University School of Medicine
Daniela Hermelin, MD Assistant Professor of Pathology, St Louis University School of Medicine; Associate Director of Transfusion Medicine, Director of Clinical Apheresis, St Louis University Hospital
Daniela Hermelin, MD is a member of the following medical societies: AABB, American Society for Apheresis, American Society for Clinical Pathology, College of American Pathologists, Heart of America Association of Blood Banks (HAABB), International Society of Blood Transfusion
Judy Lin, MD
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