URINARY DEHYDROEPIANDROSTERONE IN IDIOPATHIC HIRSUTISM: INFLUENCE OF CORTISONE THERAPY*

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Abstract
Allen''s modification of the Dirscherl-Zilliken color reaction for dehydroepiandrosterone (DHIA) was applied to the estimation of this steroid in 24-hour urine samples. Urine was hydrolyzed in the presence of 10% HC1 at 100oC. for 12 min. and extracted with carbon tetrachloride. After washing with 10% NaOH and water until neutral, the samples were dried in vacuo. The Zimmermann reaction and the Allen reaction were performed on these residues. When 2 normal women and 1 normal man were given cortisone acetate 75 mg./day by mouth for 10 days there was no modification of the urinary 17-keto-steroid (17-KS) excretion or DHIA steroid excretion. Seven women with idiopathic hirsutism were studied, several of whom also exhibited menstrual abnormalities. Four of these patients received cortisone acetate in doses similar to the controls. Three of the hirsute women excreted 17-KS in the normal range (10.3-12.2 mg./day), and 4 showed an abnormally elevated excretion of 17-KS (19.6-35.1 mg./day). All 7 hirsute women excreted excess amts. of DHIA steroids in comparison with the adult controls. The 4 women with idiopathic hirsutism who were treated with cortisone acetate showed a fall of urinary 17-KS and DHIA steroid excretion to values such as were found in controls. The data suggest that in certain patients with idiopathic hirsutism there is overproduction of 17-KS precursors. Whether these 17-KS precursors originate in a hyperplastic adrenal cortex or hyperplastic ovary is not clarified by the present study.