STUDIES ON THE METABOLISM OF ADRENAL STEROIDS IN THE ADRENOGENITAL SYNDROME*

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Abstract
Pregnanetriol (3-alpha-20-alpha-pregnanetriol) was found to be regularly present in urine of patients with the adrenogenital syndrome due to adrenocortical hyperplasia. The quantities far exceeded those found in normal urines. Admn. of cortisone to patients with adrenal hyperplasia led to the suppression of the excretion of this steroid as well as the 17-ketosteroids. Adrenocorticotropin in such patients produced an increase in its excretion whereas this did not occur when the hormone was administered to normal individuals. In addition, ACTH did not produce an increase in the blood level of corticoids in 7 of 9 patients with this disorder, although the levels generally rose in normal subjects. These data suggest that there is an inability of the adrenal cortex to convert 17-hydroxy-progesterone into 17-hydroxycorticosterone in this disease, so that the former is reduced to pregnanetriol and excreted as such in the urine.