Steroid Studies in a Case of Stein-Leventhal Syndrome with Hirsutism

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Abstract
A patient with Stein-Leventhal syndrome and hirsutism has been studied before and after wedge resection of the ovaries. The levels of urinary 17-hydroxycorticosteroids and of 11-oxygenated 17-ketosteroids were found to be somewhat higher than normal before wedge resection. The level of urinary dehydroisoandrosterone was also increased. The elevation in androsterone and etiocholanolone levels, particularly as their sulfates, was very striking. After administration of Dexamethasone, the androsterone and etiocholanolone levels in the urine remained much higher than those of control subjects. The administration of chorionic gonadotrophin during adrenocortical suppression with Dexamethasone increased the levels of androsterone and etiocholanolone sulfates in the urine. During this period, their levels in the blood were higher than that of dehydroisoandrosterone sulfate. These findings indicate that the ovaries may be a source of androgens in Stein-Leventhal syndrome, a conclusion further supported by the isolation of androstenedione and free dehydroisoandrosterone from ovarian tissue obtained at wedge resection.