ALDOSTERONE EXCRETION IN VIRILIZING ADRENAL HYPERPLASIA *

Abstract

Aldosterone excretion was measured in 19 urines of 13 patients, 4-32 years of age, who had virilizing adrenal hyperplasia without salt loss. Fourteen determinations were above the normal adult range (3-8 [mu]g/24 hr.) Six of these individuals were subsequently restricted to a Na intake of 9 meq/day for 5 days, and excretion normally increased in 5 patients to between 20-66 meq/day. In contrast, 11 patients with virilizing adrenal hyperplasia with associated salt loss excreted less than normal amounts of aldosterone, and failed to respond normally to limited salt intake with increased production. Tangential studies demonstrated that 4 normal newborn infants and 3 children, 2-3 1/2 years of age, excreted less than adult amounts of aldosterone, but probably responded with increased excretion secondary to salt deprivation. This study indicates that aldosterone excretion increases with age, and that impaired ability to synthesize aldosterone contributes to the electrolyte imbalance characteristic of patients with congenital virilizing adrenal hyperplasia with associated salt loss.