Pathology Handbook

Androstenedione

Synonyms

A4

Clinical Indications

Androstenedione is useful in investigating the cause of a high testosterone in women.  It is not as useful as 17-OH progesterone in diagnosis of congenital adrenal hyperplasia (CAH) due to 11ß- or 21-hydroxylase deficiency, but is helpful in management of such patients. In CAH due to 17ß-hydroxysteroid dehydrogenase deficiency male (46 XY) babies have female or ambiguous genitalia and at puberty, marked virilization occurs. The condition is characterised by increased androstenedione relative to that of testosterone.

Request Form

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Availability

On request

Specific Criteria

Raised testosterone in a woman; management of CAH due to 11ß- or 21-hydroxylase deficiency. Diagnosis of 17ß-hydroxysteroid dehydrogenase deficiency.

Turnaround Time

Weekly

Patient Preparation

It is advisable to avoid stress. For diagnosis of 17ß-hydroxysteroid dehydrogenase deficiency in infants, stimulation with hCG may be required to achieve serum androstenedione levels that can be measured for accurate diagnosis.

Specimen

Serum in gold-top vacutainer

Volume

1 ml

Container

Vacutainer gold top

Causes for Rejection

Unlabelled or incorrectly labelled sample; not meeting specific criteria for analysis

Reference Range

Adult:

Male: 2.1 - 12.9 nmol/L

Female: 1.0 - 12.9 nmol/L

Prepubertal children: no paediatric range