ESPE Abstracts (2015) 84 P-3-583

Insufficient Mineralocorticoid Replacement as a Predictor Factor for the TART in Boys with Congenital Adrenal Hyperplasia

Igor Chugunov, Maria Kareva, Elizaveta Orlova & Elvira Kuznecova


Endocrinology Research Center, Moscow, Russia


Background: Testicular adrenal rest tumor (TART) is one of the main causes of decreased fertility in men with congenital adrenal hyperplasia (CAH). TART may occurs in childhood but there is no currently identified factors influencing the development of this condition.

Objective and hypotheses: To study the role of glucocorticoid and mineralocorticoid undertreatment in the TART development in children and adolescents with CAH, 21-hydroxylase deficiency.

Method: We have studied 41 patients with salt-wasting (SW) form of CAH, median age 9.9 yrs (5.7; 13.4). All the patients were divided into two groups according to testis ultrasound: group 1 included patients with TARTs (30% patients (9/41)), median age 13.2 yrs (10.2; 15.9), group 2 included patients without TARTs, median age 9.9 years (5.7; 13.4). The levels of serum 17-OHP, ACTH and plasma renin activity were retrospectively evaluated during the three year period before the study and the average levels were calculated for three 1-year intervals (0–1 years, −1–2 years, −2–3 years).

Results: We have found higher levels of plasma renin activity (10.3 (6.8; 23.1) vs 3.5 (1.4; 10.8) ng/ml per h, P=0.039) in the period 0–1 in roup 1, while the level 17 OHP, ACTH didn’t differ between two groups. Plasma renin activity measurements in period 0–1 were less frequent in group 1 (1.0 (0.0; 1.0) vs 2.0 (2.0; 3.0) measurement per year; P=0,022). The levels of 17 OHP, ACTH, plasma %renin activity did not significantly differ in time periods −1–2 and −2–3 between two groups.

Conclusion: TART occurs in children with poorly controlled treatment frequently: mineralocorticoids undertreatment could be important for TARTs development.

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