17-ketosteroids in 24 hour urine

Indications: - diagnosis of pituitary Cushing's syndrome - used in conjunction with metyrapone stimulation test Reference interval: -> adult a) male: 10-25 mg/day (35-87 umol/day) b) female: 6-14 mg/day (21-49 umol/day) Increases: 1) pharmaceutical agents a) in-vivo effects -> corticotropin, danazol, gonadotropins, metyrapone, testalactone, testosterone b) chemical interferences -> cephalosporins, erythromycin, ketoprofen, meprobamate, nalidixic acid, penicillamine, spironolactone, troleandomycin 2) clinical disorders a) Cushing's syndrome b) ectopic ACTH-producing tumors c) adrenal tumors -> higher values for adrenal carcinoma than for adrenal adenoma d) virilizing forms of congenital adrenal hyperplasia e) Stein-Leventhal syndrome f) testicular tumors (large increases) g) interstitial cell tumors (large increases) h) arrhenoblastoma & lutein cell tumors of the ovary Decreases: 1) pharmaceutical agents a) in-vivo effects -> androgens, corticosteroids, corticotropin, dextropropoxyphene, estrogens, morphine (chronic), phenytoin, probenecid, pyrazinamide b) chemical interferences -> carbamazepine, chlordiazepoxide, glucose 2) clinical disorders a) Addison's disease b) congenital adrenal hyperplasia (adrenogenital syndromes) c) hypopituitarism d) hypothyroidism e) generalized wasting syndrome f) nephrosis g) primary male hypogonadism 1] Klinefelter's syndrome 2] castration Method: - colorimetric (Zimmerman) Specimen: 1) urine, 24 hours 2) preserve with boric acid & refrigerate 3) stable for at least 2 weeks & for longer periods if frozen at -20 degrees C Notes: - test has largely been replaced by serum DHEA-sulfate levels as a marker of adrenal androgen production

General

24 hour urine 17-ketosteroids in urine

References

Clinical Guide to Laboratory Tests, 3rd ed. Teitz ed., W.B. Saunders, 1995
Panel of 7 tests Laboratory Test Directory ARUP: 80650

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