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17-Hydroxyprogesterone

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Also known as: 17-OHP; 17-OH Progesterone
Formal name: 17-Hydroxyprogesterone

At a Glance

Why Get Tested?

To screen for, detect, and monitor treatment for congenital adrenal hyperplasia (CAH); sometimes to help rule out other conditions with similar symptoms

When to Get Tested?

As part of a routine newborn screen; when an infant's sex is not obvious (ambiguous genitalia); when a young female has increased growth of facial and body hair (hirsutism) or other symptoms that could be related to elevated male sex hormones (virilization); when a male child has premature sexual development; periodically to monitor CAH treatment

Sample Required?

A blood sample drawn from a vein in your arm or blood from a heelstick for an infant

Test Preparation Needed?

None, but an early morning collection may be requested; it may also be requested that the blood sample be collected at a specific time during a woman's menstrual cycle.

The Test Sample

What is being tested?

17-hydroxyprogesterone (17-OHP) is a steroid hormone, derived from cholesterol, and is produced as part of the process of making the hormone cortisol. This test measures the amount of 17-OHP in the blood to detect and/or evaluate congenital adrenal hyperplasia (CAH), an inherited condition that results in decreased adrenal cortisol and aldosterone and increased male sex hormone (androgen) production.

Cortisol is produced by the adrenal glands. It helps break down protein, glucose, and lipids, maintains blood pressure, and regulates the immune system. The adrenal glands also produce other steroid hormones such as aldosterone, which helps regulate salt levels and blood pressure, and androgens, substances that, like testosterone, cause male sexual features as well as other effects.

Several enzymes are required to complete the steps involved in the production of cortisol. If one or more of these enzymes is deficient or dysfunctional, then inadequate amounts of cortisol are produced, as occurs with CAH. The most common cause of CAH is a lack of the enzyme 21-hydroxylase, accounting for about 90% of cases.

Because a low level of cortisol causes an elevation in the level of a particular pituitary hormone that stimulates adrenal growth and hormone production (adrenocorticotropic hormone, or ACTH), the adrenal gland increases in size (adrenal hyperplasia). However, the increased size and activity cannot overcome the block in cortisol production. Other substances such as 17-hydroxyprogesterone and androgens that do not need the defective enzyme are produced in excess. This is why testing for 17-OHP can help to detect CAH.

CAH with 21-hydroxylase deficiency is inherited as either a severe or mild type:

  • Severe forms can cause babies to be born with serious deficiencies of both aldosterone and cortisol that will require medical attention. This severe form is most often detected in infancy during routine newborn screening or during early childhood. If not detected by screening, it may present in early childhood with signs and symptoms such as vomiting, listlessness, lack of energy (lethargy), not eating well, failure to thrive, dehydration and low blood pressure, particularly with acute illness.

    Due to the excess androgens, the development of male sexual characteristics in females (virilization) can occur. Female babies may have sex organs that are not clearly male or female (ambiguous genitalia), making it difficult to initially determine their sex. Females may have excess hair growth on face and body (hirsutism) and other male secondary sexual characteristics during childhood and adolescence as well as irregular menstruation. Males with this condition will appear normal at birth but may start to develop sexual characteristics prematurely.

  • In the milder, yet more common form of CAH due to 21-hydroxylase deficiency, there may be 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.

How is the sample collected for testing?

A blood sample is obtained by inserting a needle into a vein in the arm or by pricking the heel of an infant.

NOTE: If undergoing medical tests makes you or someone you care for anxious, embarrassed, or even difficult to manage, you might consider reading one or more of the following articles: Coping with Test Pain, Discomfort, and Anxiety, Tips on Blood Testing, Tips to Help Children through Their Medical Tests, and Tips to Help the Elderly through Their Medical Tests.

Another article, Follow That Sample, provides a glimpse at the collection and processing of a blood sample and throat culture.

Is any test preparation needed to ensure the quality of the sample?

No test preparation is needed, but an early morning collection may be requested. It may also be requested that the blood sample be collected at a specific time during a woman's menstrual cycle.

The Test

Common Questions

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Article Sources

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NOTE: This article is based on research that utilizes the sources cited here as well as the collective experience of the Lab Tests Online Editorial Review Board. This article is periodically reviewed by the Editorial Board and may be updated as a result of the review. Any new sources cited will be added to the list and distinguished from the original sources used.

Sources Used in Current Review

Lin, J. (Updated 2012 February 17). 17-Hydroxyprogesterone, Serum. Medscape Reference [On-line information]. Available online at http://emedicine.medscape.com/article/2089180-overview through http://emedicine.medscape.com. Accessed May 2013.

Vorvick, L. (2011 May 31). 17-OH progesterone. MedlinePlus Medical Encyclopedia [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/003713.htm through http://www.nlm.nih.gov. Accessed May 2013.

Wilson, T. (Updated 2013 June 13). Congenital Adrenal Hyperplasia. Medscape Reference [On-line information]. Available online at http://emedicine.medscape.com/article/919218-overview through http://emedicine.medscape.com. Accessed May 2013.

(Updated 2012 November 30) Congenital Adrenal Hyperplasia (CAH): Condition Information. National Institute of Child Health and Human Development [On-line information]. Available online at http://www.nichd.nih.gov/health/topics/cah/conditioninfo/Pages/default.aspx through http://www.nichd.nih.gov. Accessed May 2013.

Zieve, D. and Eltz, D. (2012 May 8). Congenital adrenal hyperplasia. MedlinePlus Medical Encyclopedia [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/000411.htm through http://www.nlm.nih.gov. Accessed May 2013.

Meikle, A. (Updated 2013 January). Congenital Adrenal Hyperplasia – CAH. ARUP Consult [On-line information]. Available online at http://www.arupconsult.com/Topics/CAH.html?client_ID=LTD through http://www.arupconsult.com. Accessed May 2013.

Elizabeth Jones, MPH. Senior Specialist, Newborn Screening and Genetics. Association of Public Health Laboratories (APHL). Silver Spring, MD.

Sources Used in Previous Reviews

Wu, A. (© 2006). Tietz Clinical Guide to Laboratory Tests, 4th Edition: Saunders Elsevier, St. Louis, MO. Pp 588-591.

Vorvick, L. (Updated 2009 April 12) 17-OH progesterone. MedlinePlus Medical Encyclopedia [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/003713.htm through http://www.nlm.nih.gov. Accessed September 2009.

Zieve, D. et. al. (Updated 2008 October 09). Congenital adrenal hyperplasia. MedlinePlus Medical Encyclopedia [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/000411.htm through http://www.nlm.nih.gov. Accessed September 2009.

Storck, S. (Updated 2008 May 12). Ovarian overproduction of androgens. MedlinePlus Medical Encyclopedia [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/001165.htm through http://www.nlm.nih.gov. Accessed September 2009.

Dowshen, S. (Reviewed 2009 January). Blood Test: 17-Hydroxyprogesterone. KidsHealth from Nemours Foundation [On-line information]. Available online at http://kidshealth.org/parent/system/medical/test_hydroxyprogesterone.html through http://kidshealth.org. Accessed September 2009.

Wilson, T. (Updated 2008 April 15). Congenital Adrenal Hyperplasia. eMedicine [On-line information]. Available online at http://emedicine.medscape.com/article/919218-overview through http://emedicine.medscape.com. Accessed September 2009.

Khan, M. (Updated 2009 September 4). Polycystic Ovarian Syndrome. eMedicine [On-line information]. Available online at http://emedicine.medscape.com/article/256806-overview through http://emedicine.medscape.com. Accessed September 2009.

Meikle, A. W. (Updated 2009 August). Congenital Adrenal Hyperplasia – CAH. ARUP Consult [On-line information]. Available online at http://www.arupconsult.com/Topics/CAH.html?client_ID=LTD# through http://www.arupconsult.com. Accessed September 2009.

Meikle, A. W. and Roberts, W. (Updated 2009 August). Polycystic Ovarian Syndrome. ARUP Consult [On-line information]. Available online at http://www.arupconsult.com/Topics/PCOS.html?client_ID=LTD through http://www.arupconsult.com. Accessed September 2009.

Bayrak-Toydemir, P. et. al. (Updated 2009 August). Infertility. ARUP Consult [On-line information]. Available online at http://www.arupconsult.com/Topics/Infertility.html?client_ID=LTD# through http://www.arupconsult.com. Accessed September 2009.

Jospe, N. (Revised 2009 May). Congenital Adrenal Hyperplasia (Adrenogenital Syndrome; Adrenal Virilism). Merck Manual for Healthcare Professionals [On-line information]. Available online at http://www.merck.com/mmpe/sec19/ch282/ch282e.html?qt=17-hydroxyprogesterone&alt=sh through http://www.merck.com. Accessed September 2009.

(© 1995–2009). Unit Code 9231:17-Hydroxyprogesterone, Serum. MayoMedical Laboratories [On-line information]. Available online at http://www.mayomedicallaboratories.com/test-catalog/print.php?unit_code=9231 through http://www.mayomedicallaboratories.com. Accessed September 2009.

Nimkarn, S. and New, M. (Updated 2009 September 15). 21-Hydroxylase-Deficient Congenital Adrenal Hyperplasia. GeneReviews [On-line information]. Available online at http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=gene∂=cah through http://www.ncbi.nlm.nih.gov. Accessed October 2009.

(Updated 2009 October 01). National Newborn Screening Status Report. National Newborn Screening and Genetics Resource Center. Available online at http://genes-r-us.uthscsa.edu/nbsdisorders.htm through http://genes-r-us.uthscsa.edu. Accessed October 2009.

Hoe F. The Children's Hospital: Presumptive Positive Screen for CAH. Available online at http://www.thechildrenshospital.org/conditions/diabetes/professionals/adrenal_hyperplasia.aspx through http://www.thechildrenshospital.org. Accessed October 2009.

The Cares Foundation. Congenital Adrenal Hyperplasia, Adrenal Crisis. Available online at http://www.caresfoundation.org/productcart/pc/adrenal_crisis.html through http://www.caresfoundation.org. Accessed October 2009.

Harrison's Principles of Internal Medicine. 16th ed. Kasper D, Braunwald E, Fauci A, Hauser S, Longo D, Jameson JL, eds. McGraw-Hill, 2005, Pg 2145.

Clarke, W. and Dufour, D. R., Editors (2006). Contemporary Practice in Clinical Chemistry, AACC Press, Washington, DC, Pg 384.

Henry's Clinical Diagnosis and Management by Laboratory Methods. 21st ed. McPherson RA and Pincus MR, eds. Philadelphia: 2007, Pg 346.

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