PREGNANEDIOL EXCRETION IN A MASCULINIZING SYNDROME

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Abstract
IN 1937, Butler and Marrian (1) first called attention to the presence of considerable quantities of pregnanediol contaminating pregnanetriol in the urine of women exhibiting signs of virilization. This phenomenon has been studied in cases of virilism, and high pregnanediol values have been detected in cases which were subsequently proven to be carcinoma of of the adrenal cortex. On only one occasion has excessive pregnanediol been found associated with benign lesions. It has been suggested that the presence of pregnanediol in the urine may be of diagnostic value in indicating the presence of adrenal carcinoma. We have had the opportunity of studying a young, white female showing obvious signs of virilism with a continual high pregnanediol excretion. Intensive study has suggested that she represents a typical example of the Stein-Leventhal syndrome. CASE REPORT This patient was first seen in October, 1949, being 18 years of age at that time. It was elicited that there was excessive body hair apparent at about the age of 10 years. The secondary sexual characteristics of the female appeared at about 15 years, although there was no menstruation. At the age of 16 years, the patient received hormones of unknown identity which resulted in six or seven episodes of withdrawal bleeding at intervals of from eight to ten weeks, but this ceased with the termination of therapy. Body and facial hair became more excessive at the age of 17 years and the patient was required to shave daily. She reported that there has never been any libido and although married at the age of 17 years, she has derived no satisfaction from her marital relations.