Would Cortisol Measurements Be a Better Gauge of Hydrocortisone Replacement Therapy? Congenital Adrenal Hyperplasia as an Exemplar

Figure 6

24-hour plasma cortisol (blue line and diamonds) and 17 hydroxyprogesterone (purple line and triangles) concentration profiles from a 16-year-old postpubertal girl with salt-wasting congenital adrenal hyperplasia receiving hydrocortisone twice daily (10 mg at 09.00 h and 7.5 mg at 21.00 h) for the previous 3 years. The dosing was hydrocortisone dosing 10 mg/m2/day and the 9-alpha fludrocortisone dose 100 micrograms per day. Blood samples are drawn at 20-minute intervals. Reproduced from Congenital Adrenal Hyperplasia: A Comprehensive Guide, Hindmarsh P and Geertsma K Elsevier, New York (2017).