Abstract:
INTRODUCTION:Testicular adrenal rest tumors (TART) are a known consequence for males with classical congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency. TART are associated with potential infertility in adults. However, little is known about TART in very young males with CAH. OBJECTIVE:We assessed the presence of TART in newborn, infant, and toddler males with classical CAH via scrotal ultrasound. METHODS:Males with CAH had scrotal ultrasounds during the first 4 years of life, evaluating testes for morphology, blood flow, and presence of TART. Newborn screen 17-hydroxyprogesterone (17-OHP) and serum 17-OHP at the time of ultrasound were recorded. Bone ages were considered very advanced if ≥2 SD above chronological age. RESULTS:Thirty-one ultrasounds in 16 males were performed. An initial ultrasound was obtained in four newborns at diagnosis (6.8 ± 2.1 days), six infants (2.2 ± 0.9 months), and six toddlers (2.4 ± 0.9 years). Eleven males had at least one repeat ultrasound. A large proportion (11/16) were in poor hormonal control with an elevated 17-OHP (325 ± 298 nmol/L). One infant was in very poor hormonal control (17-OHP 447 nmol/L) at initial ultrasound, and two toddlers had advanced bone ages (+3.2 and +4.5 SD) representing exposure to postnatal androgens. However, no TART were detected in any subjects. CONCLUSIONS:TART were not found by scrotal ultrasound in males up to 4 years of age with classical CAH despite settings with expected high ACTH drive. Further research into the occurrence of TART in CAH may elucidate factors that contribute to the detection and individual predisposition to TART.
journal_name
Horm Res Paediatrjournal_title
Hormone research in paediatricsauthors
Kim MS,Koppin CM,Mohan P,Goodarzian F,Ross HM,Geffner ME,De Filippo R,Kokorowski Pdoi
10.1159/000504135subject
Has Abstractpub_date
2019-01-01 00:00:00pages
157-161issue
3eissn
1663-2818issn
1663-2826pii
000504135journal_volume
92pub_type
杂志文章abstract:BACKGROUND:3β-hydroxysteroid dehydrogenase (3βHSD) type 2 (encoded by HSD3B2) is expressed in the adrenals and gonads. HSD3B2 mutations cause the rare form of congenital adrenal hyperplasia '3βHSD deficiency'. In its classic form, affected individuals have salt wasting early in infancy and may have ambiguous genitalia ...
journal_title:Hormone research in paediatrics
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更新日期:2015-01-01 00:00:00
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pub_type: 临床试验,杂志文章
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pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2014-01-01 00:00:00
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