ADHS: Division of Public Health Services: Office of Newborn Screening: Health Care Providers

Newborn Screening

Blood Specimens | Mandatory Reporting Forms

New kit for CAH testing
A new kit for CAH testing will be used by the Newborn Screening Program at the Arizona State Lab beginning on 9/28/09.

Cutoffs and birth weight ranges have been adjusted for the new kit. This is not a change in method for quantifying 17-OHP but is a change in the antibodies used in the PerkinElmer® AutoDelphia® Neonatal 17α-OH-progesterone kit (time-resolved fluoroimmunoassay).

The new kit is more specific for 17-OHP and values obtained minimize contributions from other hormones which may be elevated because of stress. Overall, the average results obtained are lower than the previous kit results.

Because of this downward change in values, the cutoffs have been adjusted. However, even though the cutoffs have been lowered, we anticipate a marked reduction in the number of false positives reported. When an abnormal result is reported there will be a much greater likelihood of a true positive, particularly in full-term, well babies.

Early collection (<24 hours of age) and prematurity (low birth weight) will still produce false positives although using cutoffs adjusted for birth weight will help to minimize them. The birth weight ranges have been changed to put low birth weight babies in separate categories from babies of normal birth weight (>2500 g).

We will continue to monitor our results with this test and will adjust cutoffs as needed to minimize false positives while identifying those at risk for classic CAH.

Please note that 17-OHP is elevated in the two most common forms of CAH (21-hydroxylase deficiency and 11ß-hydroxylase deficiency) but not in the other types. Its determination is thus useful as a screening method for these two most frequently seen types of CAH or about 95% of all cases. As with other screening tests, a negative result does not completely rule out the possibility of disease.

We will continue to communicate with you as we make changes to our testing and follow-up protocols for any of the disorders screened by our program. If you have any questions related to this laboratory change, please do not hesitate to contact either Dr. Sundin Applegate, NBS Medical Director, at applegs@azdhs.gov or (602) 542-1223; or Ward Jacox, NBS Office Chief at jacoxw@azdhs.gov or (602) 364-1410.

If you have clinical questions, please contact one of the pediatric endocrinologists listed below:

Dr. Donnie Wilson	Phoenix Children’s Hospital, Endocrinology	602-546-0935
Dr. Khalid Hasan	Phoenix Children’s Hospital, Endocrinology	602-546-0935
Dr. Roger Johnsonbaugh	Arizona Pediatric Endocrinology	602-274-5078
Dr. Alvin Perelman	Southwest Pediatric Endocrinology	480-323-4800
Dr. Ed Holland	East Valley Pediatric Endocrinology	480-464-8600
Dr. Mark Wheeler	University Physicians	520-626-6077

Blood Specimens

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Parent Refusal Form
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Mandatory Reporting Forms

SCREENING FORMS:

Hearing Out-Patient Screening (HOPS) Form

Community Health Center Screening Forms: Out-Patient Screening Clinic Form

TESTING FORMS:

Referral Form - PHOENIX

Referral Form - FLAGSTAFF

Referral Form - TUCSON

Referral Form - YUMA

Notification to Arizona Audiologist & Community Health Centers