Short Synacthen Test with 17 OH progesterone
Information for parents and carers
You have been given this leaflet as there have been concerns regarding your child having early pubic hair development. If after reading this leaflet you have any further questions, please contact Dolphin Ward on 01227 864052.
What is a Short Synacthen Test with 17 OH progesterone?
This test measures the amount of cortisol your child is able to produce, and their 17 OH progesterone levels.
Why has my child been referred for this test?
Children who have early pubic hair development are generally referred for this test. The test is carried out to rule out a condition (congenital adrenal hyperplasia) where cortisol levels can be lowered and 17 OH progesterone is raised.
The test is needed because sometimes random levels of 17 OH progesterone can be normal, and only rise when the body is producing larger amounts of cortisol.
When we experience physical or emotional stress the pituitary gland in our brain produces a hormone called ACTH. ACTH travels in the bloodstream to the adrenal glands and makes them produce cortisol. The adrenal glands lie just above each kidney. Synacthen is a medicine that has a similar effect to ACTH, stimulating the adrenal gland to make cortisol.
What are the benefits of doing this test?
This test is the best way of completely ruling out a diagnosis of congenital adrenal hyperplasia.
What happens if we decide not to have this test?
If you decide that you do not want your child to have this test, your doctors will have less information available about your child’s cortisol levels, and your child can only be monitored in the clinic.
What happens before my child’s test?
Your child will be given a morning appointment to come to Dolphin Ward at Kent and Canterbury Hospital for their test. They can eat and drink as normal before their test.
If your child is taking hydrocortisone or another oral steroid, please do not give it on the morning of their test.
It is important to talk to your child about their test, explaining it as simply as possible.
What happens on the day of their test?
Please report to the reception desk in the Children’s Assessment Centre at the Kent and Canterbury Hospital.
A nurse will greet you and your child, and take you both through to Dolphin Ward for your child’s test. Please use this time to ask any last minute questions. Remember that you can withdraw your consent for treatment at any time, should you change your mind and wish to do so.
You can stay with your child while they have their test.
Anaesthetic cream will be applied to numb the area, before a nurse inserts a cannula into a vein; this should not hurt. A tiny plastic tube remains in the vein and the cannula acts as a “tap”, so blood can be taken repeatedly without having to keep inserting needles to collect it.
After baseline blood tests, an injection of synacthen is given through the cannula. Following this, a blood sample is taken at 30 minutes and 60 minutes to measure the 17 OH progesterone and cortisol response.
The test usually takes around two hours to complete in total.
Once the cannula is in place your child is advised to sit on their bed but is able to do activities such as crafts, playing, using electronic devices (such as tablets and smart phones), or watching TV. Bringing things with you to help entertain your child would be helpful.
Once the test is complete, you can go home.
Are there any side effects to having this test?
Synacthen can cause side effects but this is very unusual. Rarely, synacthen can cause flushing and a feeling of sickness and sleepiness. Very rarely patients may have an allergic reaction with skin irritation, swelling, or wheeziness.
When will the results be available?
Results are usually available one to two weeks after the test. They will be discussed at your child’s next clinic appointment or you will be informed by letter or phone call.
Contact details
If you are unable to come to your appointment or you have any questions or concerns about the test, please contact Dolphin Ward on 01227 864052.