17-Hydroxy Progesterone, Urine

Clinical Significance:
17-Hydroxy Progesterone is a steroid derived primarily from enzymatic metabolism of Progesterone and 17-Hydroxy Pregnenolone.  It is converted enzymatically to Androstenedione and 11-Deoxycortisol.  It is produced in both the gonads and adrenal glands.  It is excreted into the urine in conjugated and unconjugated forms of 17-Hydroxy Progesterone and as Pregnanetriol.  This assay measures the total of the conjugated and unconjugated forms.  It is stimulated by ACTH and supressed by Dexamethasone.  Levels of urine 17-Hydroxy Progesterone are greatly increased in patients with Polycystic Ovarian Disease and Congenital Adrenal Hyperplasia and show exaggerated responses to ACTH in these cases.  17-Hydroxy Progesterone is the marker steroid for determining cases of 21a-Hydroxylase Deficient Congenital Adrenal Hyperplasia.  Urine levels are frequently elevated in patients with idiopathic hirsutism. 

Reference Ranges:
Male:                          Up to 2.0 ug/24 hours
Female:                      Up to 4.5 ug/24 hours

Procedure:
Urine 17-Hydroxy Progesterone is measured by radioimmunoassay.

Patient Preparation:
Patient should not be on any Corticosteroid, ACTH, Estrogen, or Gonadotropin medications, if possible, for at least 48 hours prior to collection of specimen.

Specimen Collection:
10 ml of a 24 hour urine collection should be submitted for analysis. No special preservatives are required. Store specimen refrigerated during collection. Specimens should be frozen prior to shipping. Minimum specimen size is 5 ml.

Shipping Instructions:
Ship specimens frozen in dry ice. Provide the total volume per 24 hours.

References:
1. E Carmina and RA Lobo.  Pituitary-Adrenal Responses to Corticotropin-Releasing Factor in Late Onset 21-Hydroxylase Deficiency.  Fertility and Sterility 54: 79-83, 1990.

2. ET Wong, DR Brown, RA Ulstrom, and MW Steffes.  Urinary 17-alpha-Hydroxyprogesterone in Diagnosis and Management of Congenital Adrenal Hyperplasia.  Journal of Clinical Endocrinology and Metabolism 49: 377, 1979.