Tan S Y, Donabedian R, Genel M, Mulrow P J
J Lab Clin Med. 1977 Apr;89(4):735-40.
Plasma cortisol values in seven patients with the 21-hydroxylase variant of CAH ranged from 9 to 35 micron/100 ml. (mean+/-S.E.=22+/-4) as determined fluorimetrically and from 22 to 35 microng/100 ml. (26+/-2) by competitive protein-binding radioassay. In these same patients the cortisol values obtained after Sephadex LH-20 column chromatography were much lower, ranging from 1 to 12.5 microng/100 ml. (5+/-2, p less than 0.01). In six normal subjects, cortisol values were similar before and after chromatography. Plasma concentrations of progesterone, 17alpha-hydroxyprogesterone, and 21-deoxycortisol in the CAH patients were increased 10 to 100-fold. The elevated cortisol values determined by customary methods were shown to be due to cross-interference of these and other steroids in the assays. Plasma cortisol values obtained routinely are falsely elevated and therefore misleading as a gauge of adrenal insufficiency in CAH.
7例患有21-羟化酶变异型先天性肾上腺皮质增生症（CAH）患者的血浆皮质醇值，通过荧光法测定为9至35微克/100毫升（均值±标准误=22±4），通过竞争性蛋白结合放射分析法测定为22至35微克/100毫升（26±2）。在这些相同患者中，经葡聚糖凝胶LH - 20柱色谱法处理后获得的皮质醇值要低得多，范围为1至12.5微克/100毫升（5±2，p<0.01）。在6名正常受试者中，色谱分析前后的皮质醇值相似。CAH患者血浆中孕酮、17α-羟孕酮和21-脱氧皮质醇的浓度升高了10至100倍。常规方法测定的升高的皮质醇值被证明是由于这些及其他类固醇在检测中存在交叉干扰。常规获得的血浆皮质醇值被错误地升高，因此作为CAH肾上腺功能不全的指标会产生误导。
