Blood

17-hydroxyprogesterone (17-OHP)

£111.55 Price excludes a visit fee
Product Code: 17OH Turnaround time: 5 days
Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the patient. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary.

This test measures the amount of 17-hydroxyprogesterone (17-OHP) in the blood. 17-OHP is a steroid that is metabolised to make cortisol; it is a substance used by the body to make cortisol. Cortisol is a hormone produced by the adrenal glands that helps break down protein, glucose, and lipids maintain blood pressure and regulate the immune system. The production of cortisol is stimulated by adrenocorticotropic hormone (ACTH), a hormone produced by the pituitary gland. Concentrations of cortisol normally vary throughout the day, peaking around 8 am and declining in the evening. Concentrations became elevated during illness and stress.

Several enzymes are required to convert 17-OHP to cortisol. If one or more of the enzymes is deficient or dysfunctional, then inadequate amounts of cortisol are produced and cortisol precursors concentrations, such as 17-OHP, increase in the blood. The adrenal glands use up some of the excess 17-OHP by producing more androgens. Excess androgens can cause virilisation i.e. the development of male sexual characteristics, in both males and females. These enzyme deficiencies are inherited and the resulting excess androgens lead to a group of disorders called congenital adrenal hyperplasia (CAH). The most common cause of CAH is a lack of the enzyme 21-hydroxylase, accounting for about 90% of cases. This enzyme is the first in the chain of enzymes converting 17-OHP to cortisol. CAH is inherited as either a severe or mild type.

In the more serious form of CAH, severe 21-hydroxylase deficiencies and the influence of excess androgens can cause female babies to be born with ambiguous genitalia, i.e it makes it difficult to initially determine if they are male or female. Males with this condition will appear normal at birth but start to develop sexual characteristics earlier in childhood than normal. Females at birth have ambiguous genitalia and later may develop hirsutism during childhood and adolescence, have irregular menstruation, and have other signs of virilization.

Up to 75% of males and females affected by 21- hydroxylase deficiency CAH will also produce less aldosterone, an adrenal hormone that regulates the retention of salt. This can lead to life-threatening “salt-wasting” crises in male and female newborns in which too much fluid and salt are lost in the urine. Those affected may have low blood sodium levels (hyponatremia), high blood potassium levels (hyperkalemia), decreased aldosterone and increased plasma renin activity. The severe, though the less common form, is most often detected in infancy during routine newborn screening or during early childhood.

In the milder, yet more common form of this disorder, there may be an only partial deficiency of the enzyme. This type, sometimes called late-onset or non-classical CAH, can have symptoms that begin to appear any time during childhood, adolescence, or adulthood. The symptoms can be vague, may develop slowly over time, and may vary from person to person. Though this form of CAH is not life-threatening, it may cause problems with growth, development, and puberty in children and may lead to infertility in adults. In adolescence and adulthood, it is mainly females who are diagnosed. In a family with a history of CAH, an adult male with infertility should be investigated for CAH.

There is no preparation such as fasting for this test, but the doctor may request an early morning collection. The doctor may also request that blood be collected in the first half of a woman’s menstrual cycle.

The 17-OHP test is requested as part of a newborn screen when a child has ambiguous genitalia and may be repeated if the screening test is elevated to confirm the initial results. A 17-OHP test may be requested whenever an infant has signs and symptoms of adrenal insufficiency or experiences salt-wasting crises. Some signs and symptoms may include:

  • Listlessness, lack of energy (lethargy)
  • Not eating well
  • Dehydration
  • Low blood pressure

An infant with CAH may also have ambiguous genitalia, virilisation, acne, or pubic hair. This test may sometimes be requested in older children or in adults when the milder form of CAH (late-onset) is suspected. The 17-OHP test may also be conducted when a girl or woman is experiencing symptoms such as:

  • Hirsutism
  • Lack of or irregular periods (menses)
  • Virilization
  • Infertility

In women, the symptoms are very similar to those of polycystic ovarian syndrome (PCOS). Boys or men may experience:

  • Early (precocious) puberty
  • Infertility

When a person has been diagnosed with 21-hydroxylase deficiency, then a 17-OHP test may be requested periodically to monitor the effectiveness of treatment.

If a newborn or infant has significantly increased concentrations of 17-OHP, then it is likely that he or she has CAH. If a person has moderately increased concentrations, then they may have a less severe case of CAH, may have a deficiency of another enzyme associated with CAH, 11-beta-hydroxylase or may have a false positive test.

Normal 17-OHP results mean that it is likely that the person does not have CAH due to a 21-hydroxylase deficiency. Low or decreasing concentrations in a person with CAH indicate a response to treatment. High or increasing concentrations may indicate that changes in treatment are required.

Disclaimer

The laboratory test results are NOT to be interpreted as results of a "stand-alone" test. The test results have to be interpreted after correlating with suitable clinical findings and additional supplemental tests/information. Your healthcare providers will explain the meaning of your tests results, based on the overall clinical scenario.

Certain medications that you may be currently taking may influence the outcome of the test. Hence, it is important to inform your healthcare provider of the complete list of medications (including any herbal supplements) you are currently taking. This will help the healthcare provider interpret your test results more accurately and avoid unnecessary chances of a misdiagnosis.

This test is found in these product packages
Polycystic Ovary Syndrome profile
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