Assays / Hormones / 17a-Hydroxyprogesterone (saliva)

Clinical Use
Monitoring corticosteroid replacement therapy in children with congenital adrenal hyperplasia due to 21-hydroxylase deficiency.

The use of saliva permits collection of multiple samples in a non-invasive manner in a stress-free (home) environment. Corticosteroid dose can be adjusted until salivary concentrations throughout the day fall within defined limits.

Patient Preparation
None, but saliva must be collected in the following manner:

• Rinse mouth thoroughly with water to remove food debris;
• After 5 - 10 min, allow saliva to collect in floor of mouth;
• Gently express saliva into the collecting vial;
• Repeat 2 & 3 until at least l mL saliva (excluding froth) has been collected.

Saliva may be obtained from a very young child by gentle suction.

Collect saliva at the following times:

First sample	Before taking early morning dose of steroid
Second sample	Between 11.00h and 13.00h
Third sample	Between 15.00h and 17.00h
Fourth sample	Before taking late night dose of steroid

Sample Preparation
During collection of saliva at home, store the samples at 4C. Store samples in the laboratory at -20C before despatch. Send saliva samples (minimum of 1 mL) to the SAS laboratory.

Reference Ranges
The following concentrations are associated with treatment judged to be adequate by accepted criteria: