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J Rodríguez Espinosa

Publications and source records attributed to J Rodríguez Espinosa.

8 recordsLinked to original sources
PubMed1994

[Strategies in screening of nonclassical forms of congenital adrenal hyperplasia caused by P450c21 deficiency in hyperandrogenic women].

BACKGROUND: The value of the measurement of the serum level of 17-hydroxyprogresterone (170HP) and the stimulation test with adrenocorticotropin (ACTH) with and without previous slowing with dexamethasone was determined to detect congenital adrenal hyperplasia (CSH) due to a deficiency of P450c21 in hyperandrogenic women. METHODS: Three hundred seventy women consecutively attended for hyperandrogenism were studied. Stimulation tests of 170HP were performed with 250 micrograms i.v. of synthetic ACTH with previous administration of 1 mg of dexamethasone in 191 of the patients. The test was performed without previous dexamethasone in the remaining 179 patients. RESULTS: Nineteen patients with unclassical forms of CSH by deficiency of P450c21 were detected. Another 19 were considered as probable heterozygotes. The basal levels of 170HP with and without previous dexamethasone showed negative predictive value of nearly 100%, indicating the validity of their use in selecting patients for the stimulation test. No significant differences were seen in the increases of post ACTH 170HP observed between the tests carried out with and without dexamethasone. CONCLUSIONS: The frequency of congenital adrenal hyperplasia by deficiency of P450c21 in the hyperandrogenic women studied was found to be 5.1%. The low frequency together with the predictive value of the basal concentrations of 170HP indicate that the systematic routine use of the ACTH test as a means of scrutiny of CSH in hyperandrogenic women is unjustified.

17-alpha-Hydroxyprogesterone↗
PubMed1990

[Evaluation of a new strategy for detecting thyroid dysfunction].

The results of a diagnostic strategy to evaluate thyroid function were assessed. This strategy consists of TSH measurement as the initial biochemical test, assuming that all individuals with normal TSH concentrations are euthyroid and do not require additional measurements of other hormones. The study was carried out in 576 patients whose serum samples had been referred to the laboratory during 4 consecutive weeks for the evaluation of thyroid function. In all cases TSH and free T4 (FT4) concentrations were measured by chemoluminescence, using one tube for each parameter and patient. Total T3 concentrations (T3) were only measured (RIA) in patients with subnormal TSH values, using duplicate samples. With TSH measurement as the initial test, 447 patients (78%) in whom further hormone assessment would not have been required were detected. This rate would have been 75% if FT4 measurement had been adopted as the screening test. In addition, 55 patients with subclinical thyroid dysfunction were identified with TSH measurement. They would have been missed if the screening had been based on FT4 only. T3 measurement only contributed to the identification of one patient with T3 thyrotoxicosis, and it did not provide additional useful information for the diagnostic classification of the remaining patients. The results of these assays show that TSH measurement is the biochemical test of choice as the first step of a strategy to detect thyroid dysfunction. Its use to this end makes the concomitant measurement of other hormonal parameters unnecessary, resulting in a considerable reduction of cost.

Adolescent↗