{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T01:18:35Z","timestamp":1785547115538,"version":"3.56.0"},"reference-count":44,"publisher":"The Endocrine Society","issue":"8","license":[{"start":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T00:00:00Z","timestamp":1773187200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001807","name":"FAPESP","doi-asserted-by":"publisher","award":["#2014\/07878-4"],"award-info":[{"award-number":["#2014\/07878-4"]}],"id":[{"id":"10.13039\/501100001807","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001807","name":"FAPESP","doi-asserted-by":"publisher","award":["#2023\/11168-1"],"award-info":[{"award-number":["#2023\/11168-1"]}],"id":[{"id":"10.13039\/501100001807","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001807","name":"FAPESP","doi-asserted-by":"publisher","award":["#2023\/16309-2"],"award-info":[{"award-number":["#2023\/16309-2"]}],"id":[{"id":"10.13039\/501100001807","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001807","name":"FAPESP","doi-asserted-by":"publisher","award":["#303183\/2020-9"],"award-info":[{"award-number":["#303183\/2020-9"]}],"id":[{"id":"10.13039\/501100001807","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001807","name":"FAPESP","doi-asserted-by":"publisher","award":["#307571\/2021-1"],"award-info":[{"award-number":["#307571\/2021-1"]}],"id":[{"id":"10.13039\/501100001807","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001807","name":"FAPESP","doi-asserted-by":"publisher","award":["#308871\/2022-7"],"award-info":[{"award-number":["#308871\/2022-7"]}],"id":[{"id":"10.13039\/501100001807","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Context<\/jats:title>\n                    <jats:p>The main challenge in congenital adrenal hyperplasia newborn screening (NBS) is the high rate of false-positive results, emphasizing the need for specific serum confirmatory tests. Data on the effectiveness of serum 17-hydroxyprogesterone (17OHP) measurements using available methodologies remain limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate the efficacy of confirmatory tests using measurements of serum steroids by radioimmunoassay (RIA) and liquid chromatography tandem mass spectrometry (LC-MS\/MS) methodologies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design and Setting<\/jats:title>\n                    <jats:p>A prospective longitudinal cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients<\/jats:title>\n                    <jats:p>Data of 708 437 newborns (NBs) were evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Neonatal-17OHP (N17OHP) results \u2265 2 \u00d7 99.5th were recalled for serum dosages by RIA (17OHP), by LC-MS\/MS (17OHP, 21-deoxycortisol-21DF, androstenedione-\u03944, and cortisol) and positive predictive values (PPV) were determined. Altered hormonal results were submitted to CYP21A2 genotyping. Nonparametric tests and receiver operating characteristic (ROC)-curves were used.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Recall rate of N17OHP (first tier) was 0.03% and serum 17OHP levels remained increased in 26% (RIA) and 11% (LC-MS\/MS) of NBs, yielding PPV of 30% and 49%, respectively. Fifty-eight NBs were diagnosed with classical forms, and 32 asymptomatic NBs persisted with increased serum 17OHP levels. ROC-curves between false and true-positive tests disclosed highest diagnostic performance for 17OHP\/LC-MS\/MS [cutoff 48.3 ng\/mL (146.3 nmol\/L) = 100%-sensitivity]. The (17OHP+\u03944)\/cortisol ratio presented the highest discriminative ability (cutoff 24.9 = 100%-PPV); serum 21DF presented a good performance and was comparable to 17OHP measured by LC-MS\/MS (99%-specificity).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Measurement of 17OHP by LC-MS\/MS provides the best performance for serum confirmatory tests and may be complemented by the (17OHP+\u03944)\/cortisol ratio analysis. Genotyping is useful mainly to resolve persistently indeterminate biochemical results.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1210\/clinem\/dgag107","type":"journal-article","created":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T12:39:21Z","timestamp":1773146361000},"page":"2210-2219","source":"Crossref","is-referenced-by-count":2,"title":["Efficacy of Liquid-chromatography and Radioimmunoassay in False-positives\u2019 Drop-off in CAH Newborn Screening"],"prefix":"10.1210","volume":"111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6856-6551","authenticated-orcid":false,"given":"Daniel F","family":"Carvalho","sequence":"first","affiliation":[{"name":"Laborat\u00f3rio de Horm\u00f4nios e Gen\u00e9tica Molecular - LIM\/42, Unidade de Endocrinologia do Desenvolvimento, Disciplina de Endocrinologia e Metabologia, Hospital das Cl\u00ednicas, Faculdade de Medicina da Universidade de S\u00e3o Paulo, S\u00e3o Paulo 05403-900, Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5292-2571","authenticated-orcid":false,"given":"Helena P","family":"Lima-Valassi","sequence":"additional","affiliation":[{"name":"Laborat\u00f3rio de Cromatografia e Espectrometria de Massa (AE06-LCMS), Disciplina de Endocrinologia e Metabologia, Hospital das Cl\u00ednicas, Faculdade de Medicina da Universidade de S\u00e3o Paulo, S\u00e3o Paulo 05403-900, Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giselle Y","family":"Hayashi","sequence":"additional","affiliation":[{"name":"Instituto J\u00f4 Clemente , S\u00e3o Paulo 04040-033 ,","place":["Brasil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2224-6709","authenticated-orcid":false,"given":"Ana C M","family":"Oliveira","sequence":"additional","affiliation":[{"name":"Laborat\u00f3rio de Horm\u00f4nios e Gen\u00e9tica Molecular - LIM\/42, Unidade de 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