THE IDENTIFICATION and measurement of adrenocortical steroids in body fluids over the past 2 decades have made possible an extensive exploration of adrenal function. This review is restricted to adrenocortical metabolism in the fetus, infant and child. No attempt will be made to cover all of this rapidly developing area of endeavor. Certain aspects have been treated in other review articles, to which the reader is referred. The reviews by Moore on fetal endorinology, Klein on neonatal adrenal physiology, Lieberman and Teich and Roberts and Szego on steroid biochemistry, White and Wettstein and Anner on adrenal cortical hormones, Ingle on cortisone and Gaunt, Renzi and Chart on aldosterone are especially useful. The books by Wilkins and by Talbot and colleagues contain helpful treatments of this area. Due to the prolific nature of even the review literature, it is necessary to make a rather arbitrary selection of material.
Within recent years a number of methods have been developed for the estimation of hormones in urine and plasma. Several techniques for the chromatographic separation of the 17-ketosteroids in urine have been described. Of particular value in the diagnosis of virilizing adrenal tumor has been the development of colorimetric methods for the estimation of dehydroepiandrosterone in urine. Some progress has been made in the estimation of corticosteroids in the urine. Techniques for the measurement of 11-oxygenated neutral 17-ketosteroids, pregnanetriol and pregnanediol in the urine of patients with congenital adrenal hyperplasia have been described.
There has been a blossoming of methods for estimating steroids in plasma. Several varieties of techniques are now available for the measurement of corticosteroids and 17-ketosteroids in plasma.