Type of test Urine (24-hour)

Normal findings

Adult

Male: 3-10 mg/24 hr or 8.3-27.6 μmol/day (SI units)
Female: 2-8 mg/24 hr or 5.2-22.1 μmol/day (SI units)

Elderly: values slightly lower than that of an adult

 Children :  < 8 years: < 1.5 mg/24 hr ,, 8-12 years: < 4.5 mg/24 hr

Test explanation and related physiology

Elevated levels of 17-OCHS are seen in patients with hyper functioning of the adrenal gland (Cushing syndrome), whether this condition is caused by a pituitary or adrenal tumor, bilateral adrenal hyperplasia, or ectopic tumors producing adrenocorticotropic hormone (ACTH). Low levels of 17-OCHS are seen in patients who have a hypofunctioning adrenal gland (Addison disease) as a result of destruction of the adrenals (by hemorrhage, infarction, metastatic tumor, or autoimmunity), surgical removal of an adrenal gland, congenital enzyme deficiency, hypopituitarism, or adrenal suppression after prolonged exogenous steroid ingestion.

Testing the urine for this hormone metabolite is only an indirect measure of adrenal function. Urine and plasma levels of cortisol provide a much more accurate measurement of adrenal function. Because the excretion of cortisol metabolites follows a diurnal variation, a 24-hour collection is necessary.

 Interfering factors

• Emotional and physical stress (e.g., infection) and licorice ingestion may cause increased adrenal activity.

* Drugs that may cause increased 17-OCHS levels include acetazolamide, chloral hydrate, chlorpromazine, colchicine, erythromycin, meprobamate, paraldehyde, quinidine, qui nine, and spironolactone.

* Drugs that may cause decreased levels include estrogens, oral contraceptives, phenothiazines, and reserpine.

Procedure and patient care

• See inside front cover for Routine Urine Testing.

• Note that drugs are usually withheld several days before the urine collection. Check with the physician and laboratory for specific guidelines.

• Assess the patient for signs of stress and report these to the physician.

Abnormal findings

 Increased levels

- Cushing syndrome

- Ectopic ACTH-producing tumors

- Stress

- Adrenal adenoma or carcinoma

- Hyperthyroidism

- Obesity

Decreased levels

- Adrenal hyperplasia (adrenogenital syndrome)

- Addison disease

- Adrenal suppression from steroid therapy

- Hypopituitarism

- Hypothyroidism

مواضيع ذات صلة

Diagnosis of Familial Dyslipidemia

Lipid Profile

5-hydroxyindoleacetic acid (5-HIAA)

Diagnosis of Dyslipidemia

Familial Hypercholesterolemia

human T-cell lymphotropic virus (HTLV) I/II antibody

human placental lactogen (hPL, Human chorionic somatomammotropin [HCS])

human papillomavirus (HPV test, HPV DNA testing, HPV Genotyping, HPV mRNA testing)

human lymphocyte antigen B27 (HLA-B27 antigen, Human leukocyte A antigen, White blood cell antigens, Histocompatibility leukocyte A antigen)

Nucleic Acid –Based Tests

human chorionic gonadotropin (hCG, Pregnancy tests, hCG beta subunit)

homocysteine (Hcy)