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Representative reference ranges expected for serum androgens and steroid precursors in normal females and premature adrenarche (radioimmunoassay)*

Representative reference ranges expected for serum androgens and steroid precursors in normal females and premature adrenarche (radioimmunoassay)*
  17-hydroxy-pregnenolone (ng/dL) 17-hydroxy-progesterone (ng/dL) 11-deoxy-cortisol (ng/dL) Cortisol (microgram/dL) DHEAS (microgram/dL) DHEA (ng/dL) Androstenedione (ng/dL) Testosterone (ng/dL)
Baseline (8:00 AM)
Children, 1 to 5 years old 10-105 5-115 20-160 3-20 5-35 20-130 10-50 <20
Children, 6 to 10 years old 10-200 5-115 20-160 3-20 10-115 20-345 10-75 <20
Premature adrenarche 20-350 5-200 20-160 3-20 40-130 50-600 20-75 10-35
Early pubertal girls 35-350 15-200 20-160 3-20 35-130 40-600 40-175 10-35
Adult females, follicular phaseΔ 55-360 15-200 20-160 3-20 75-255 100-850 60-200 20-60
After ACTH1-24 (cosyntropin); values are measured 30 to 60 minutes after ≥10 microgram/m2 IV
Children, 1 to 5 years old 45-350 50-335 95-300 17-45 5-35 25-100 15-70 <20
Children, 6 to 10 years old 60-650 85-335 95-300 17-45 10-115 70-320 25-100 <20
Premature adrenarche 80-750 85-335 95-300 17-45 40-130 80-725 25-230 10-35
Early pubertal girls 150-750 90-335 95-300 17-45 35-130 70-725 55-230 10-35
Adult females, follicular phase 150-1070 35-335 95-300 17-45 75-255 250-1470 60-250 20-60
Conversion multipliers to SI units 0.0316 (nmol/L) 0.0303 (nmol/L) 0.0289 (nmol/L) 0.0276 (micromol/L) 0.0271 (micromol/L) 0.0347 (nmol/L) 0.0349 (nmol/L) 0.0347 (nmol/L)

DHEA: dehydroepiandrosterone; DHEAS: dehydroepiandrosterone sulfate; IV: intravenously; SI units: International System of Units; LC-MSMS: liquid chromatography-tandem mass spectrometry.

* Values are from a standard specialty laboratory reference (2020) using radioimmunoassay after preparatory chromatography, except cortisol and DHEAS, which were measured by direct immunoassay. Values differ slightly among laboratories. These values generally agree with those by LC-MSMS methodology, except LC-MSMS yields DHEAS values approximately 55% lower[1].

¶ Normal women who are heterozygous for 21-hydroxylase deficiency often have 17-hydroxyprogesterone responses to ACTH greater than those shown. This genotype is present in approximately 2% of women[2].

Δ 17-hydroxyprogesterone begins rising in the preovulatory phase and peaks as high as 400 ng/dL in the luteal phase of the cycle.
References:
  1. Rosenfield RL. Normal and Premature Adrenarche. Endocr Rev 2021; 42:783.
  2. Speiser PW, Arlt W, Auchus RJ, et al. Congenital Adrenal Hyperplasia Due to Steroid 21-Hydroxylase Deficiency: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab 2018; 103:4043.

Modified with permission from: Rosenfield R. Clinical review: Identifying children at risk for polycystic ovary syndrome. J Endocrinol Metab 2007; 92:787. http://jcem.endojournals.org/. Copyright © 2007 The Endocrine Society.

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