Influence of spironolactone on neonatal screening for congenital adrenal hyperplasia. Issue 3 (1st November 1999)

• Record Type: Journal Article
• Authors: Terai, Itaru; Yamano, Kimiaki; Ichihara, Naoshi; Arai, Junri; Kobayashi, Kunihiko
• Is Part Of: Archives of disease in childhood. Volume 81:Issue 3(1999)
• Page Start: F179
• Page End: F183
• Publication Date: 1999-11-01
• Subjects: screening -- congenital adrenal hyperplasia -- 17α-hydroxyprogesterone -- spironolactone; Infants -- Diseases -- Periodicals; Newborn infants -- Diseases -- Periodicals; Fetus -- Diseases -- Periodicals; 618.920105
• DOI: 10.1136/fn.81.3.F179
• Languages: English
• ISSNs: 1359-2998

Abstract

Abstract : AIM: To determine if the diuretic spironolactone cross reacts with 17α-hydroxyprogesterone (17OHP) in an enzyme linked immunosorbent assay (ELISA) kit used for the mass screening of congenital adrenal hyperplasia. METHODS: Concentrations of 17OHP on a blood filter paper disc were measured using an ELISA kit (kit C-7: ENZAPLATE N-17α -OHP-7; Chiron, Tokyo, Japan). The cross reactivity of spironolactone and its metabolites with 17OHP was determined. The concentrations of spironolactone and its metabolites in blood were measured using HPLC (high performance liquid chromatography). RESULTS: Spironolactone cross reacted with 17OHP using kit C-7 (0.01%), by increasing 17OHP concentration in a dose dependent manner. The blood concentration of spironolactone and its metabolites was nearly 900 ng/ml, high enough to show an additive effect on the 17OHP concentration. About 12% of the false positive cases screened using the kit were due to the administration of spironolactone. CONCLUSIONS: Spironolactone interferes with 17OHP concentrations, leading to false positive test results for CAH.