METABOLISM OF THE STEROID HORMONES: ISOLATION OF 13 STEROID METABOLITES FROM A PATIENT WITH (PROBABLE) ADRENAL HYPERPLASIA1

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Abstract
This communication is a more complete report on the steroid metabolites of a patient, from whose urine the isolation of Δ?-androstenol-3(α)-one-17 (Dorfman et al., 1945), androstanediol-3(α), 11(β)-one-17 (Miller et al., 1945), and etiocholanediol-3(α), 17(α) (Miller and Dorfman, 1948), has been previously reported. The presence of a compound carrying oxygen at C11, in high concentration, was chemical evidence for adrenal involvement, and further studies were carried out to determine the nature and amount of other urinary steroids present. The results are in agreement with the findings characteristic of adrenal cortical hyperplasia: an increased excretion of 3(α)hydroxy steroids, carrying labels of the adrenal cortical hormones (oxygen substitution at C11 and C17 of the steroid nucleus), together with a slight or negligible increase in excretion of 3(β)hydroxy steroids which are characteristically predominant in adrenal cortical carcinoma. The clinical picture of this patient (Wisconsin General Hospital No. 127483), who presented symptoms of virilism, has been described previously (Dorfman, et al., 1945).