{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,26]],"date-time":"2025-10-26T14:28:13Z","timestamp":1761488893284,"version":"3.40.5"},"reference-count":10,"publisher":"American Academy of Pediatrics (AAP)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2012,5,1]]},"abstract":"<jats:p>Premature infants are known to have elevated 17-hydroxyprogesterone and adrenal androgen concentrations immediately after birth, but the levels decrease rapidly. Virilization of normal premature female infants as a result of these high androgens has not been described. Three premature female infants born at 24 to 25 weeks\u2019 gestation, with birth weights 550 to 880 g and significant neonatal complications were noted to develop clitoromegaly 2 weeks to 3 months after birth. All 3 had elevated 17-hydroxyprogesterone &amp;gt;100 nmol\/L and testosterone &amp;gt;3 nmol\/L concentrations. All were treated as simple virilizing 21-hydroxylase deficiency, but subsequent genetic analysis revealed no CYP21 mutations. Follow-up after discontinuation of treatment revealed no recurrent virilization and normal adrenal steroid levels. Postnatal virilization in sick premature girls may occur, and investigations may suggest 21-hydroxylase deficiency. Genetic analysis of CYP21 should be performed before the diagnosis is confirmed. Further studies are needed to better document the natural history and possible causes of postnatal adrenal androgen secretion in sick premature infants.<\/jats:p>","DOI":"10.1542\/peds.2011-1895","type":"journal-article","created":{"date-parts":[[2012,4,3]],"date-time":"2012-04-03T00:20:28Z","timestamp":1333412428000},"page":"e1364-e1367","source":"Crossref","is-referenced-by-count":9,"title":["Postnatal Virilization Mimicking 21-Hydroxylase Deficiency in 3 Very Premature Infants"],"prefix":"10.1542","volume":"129","author":[{"given":"Robert","family":"Couch","sequence":"first","affiliation":[{"name":"Department of Pediatrics, University of Alberta and Stollery Children\u2019s Hospital, Edmonton, Alberta, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rose","family":"Girgis","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Alberta and Stollery Children\u2019s Hospital, Edmonton, Alberta, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"417","published-online":{"date-parts":[[2012,5,1]]},"reference":[{"issue":"6","key":"2022051611145544200_B1","doi-asserted-by":"crossref","first-page":"647","DOI":"10.1007\/s00431-007-0565-1","article-title":"Reference levels for 17-hydroxyprogesterone, 11-desoxycortisol, cortisol, testosterone, dehydroepiandrosterone sulfate and androstenedione in infants from birth to six months of age.","volume":"167","author":"Garagorri","year":"2008","journal-title":"Eur J Pediatr"},{"issue":"5","key":"2022051611145544200_B2","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1203\/00006450-198805000-00018","article-title":"Plasma mineralocorticoids, glucocorticoids, and progestins in premature infants: longitudinal study during the first week of life.","volume":"23","author":"Doerr","year":"1988","journal-title":"Pediatr Res"},{"issue":"6","key":"2022051611145544200_B3","doi-asserted-by":"crossref","first-page":"1133","DOI":"10.1210\/jcem-69-6-1133","article-title":"Serum adrenal steroid concentrations in premature infants.","volume":"69","author":"Lee","year":"1989","journal-title":"J Clin Endocrinol Metab"},{"issue":"3","key":"2022051611145544200_B4","doi-asserted-by":"crossref","first-page":"F175","DOI":"10.1136\/fn.81.3.F175","article-title":"Longitudinal measurements of 17alpha-hydroxyprogesterone in premature infants during the first three months of life.","volume":"81","author":"Linder","year":"1999","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"issue":"2","key":"2022051611145544200_B5","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1210\/jcem-52-2-235","article-title":"Enhanced activity of the pituitary-gonadal axis in premature human infants.","volume":"52","author":"Tapanainen","year":"1981","journal-title":"J Clin Endocrinol Metab"},{"issue":"9","key":"2022051611145544200_B6","doi-asserted-by":"crossref","first-page":"4133","DOI":"10.1210\/jc.2009-2631","article-title":"Congenital adrenal hyperplasia due to steroid 21-hydroxylase deficiency: an Endocrine Society clinical practice guideline.","volume":"95","author":"Speiser","year":"2010","journal-title":"J Clin Endocrinol Metab"},{"issue":"2 pt 1","key":"2022051611145544200_B7","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1016\/S0022-3476(05)80439-1","article-title":"The clitoral index: a determination of clitoral size in normal girls and in girls with abnormal sexual development.","volume":"120","author":"Sane","year":"1992","journal-title":"J Pediatr"},{"key":"2022051611145544200_B8","doi-asserted-by":"crossref","first-page":"701","DOI":"10.1136\/adc.65.7_Spec_No.701","article-title":"Virilisation of female preterm infants.","volume":"65","author":"Midgley","year":"1990","journal-title":"Arch Dis Child"},{"issue":"2","key":"2022051611145544200_B9","first-page":"266","article-title":"Adrenal steroidogenesis in very low birth weight preterm infants.","volume":"78","author":"Hingre","year":"1994","journal-title":"J Clin Endocrinol Metab"},{"issue":"5","key":"2022051611145544200_B10","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1203\/00006450-200011000-00013","article-title":"Adrenal function in sick very preterm infants.","volume":"48","author":"Huysman","year":"2000","journal-title":"Pediatr Res"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/129\/5\/e1364\/896438\/peds_2011-1895.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/129\/5\/e1364\/896438\/peds_2011-1895.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,5,16]],"date-time":"2022-05-16T11:15:10Z","timestamp":1652699710000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/129\/5\/e1364\/73804\/Postnatal-Virilization-Mimicking-21-Hydroxylase"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,5,1]]},"references-count":10,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2012,5,1]]},"published-print":{"date-parts":[[2012,5,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.2011-1895","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"type":"print","value":"0031-4005"},{"type":"electronic","value":"1098-4275"}],"subject":[],"published":{"date-parts":[[2012,5,1]]}}}