Using spectrophotometry, the pregnanetriol test determines urine levels of pregnanetriol, the metabolite of the cortisol precursor 17-hydroxyprogesterone. Pregnanetriol is normally excreted in the urine in minute amounts. However, when cortisol biosynthesis is impaired at the point of 17-hydroxyprogesterone conversion, urinary excretion of pregnanetriol rises significantly.
Elevated urine pregnanetriollevels suggest adrenogenital syndrome. Urine 17-ketosteroids and urine 17-ketogenic steroids may be measured concurrently to assess androgen levels. Elevated androgen levels are characteristic of adrenogenital syndrome (congenital adrenal hyperplasia).
Procedure and posttest care
The normal rate of pregnanetriol excretion ranges as follows.
Elevated urine pregnanetriollevels suggest adrenogenital syndrome: excessive adrenal androgen secretion and resulting virilization. Females with this condition fail to develop normal secondary sex characteristics and show marked masculinization of external genitalia at birth. Males usually appear normal at birth but later develop signs of somatic and sexual precocity.
In monitoring treatment with cortisol replacement, elevated urine pregnanetriol levels indicate insufficient dosage of cortisol. When cortisol replacement adequately inhibits hypersecretion of corticotropin and subsequent overproduction of 17-hydroxyprogesterone, pregnanetriollevels fall within the normal range.
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