AN ABNORMALITY IN STEROID REDUCTIVE METABOLISM IN A HYPERTENSIVE SYNDROME

Abstract

Studies in a juvenile hypertensive syndrome associated with suppressed plasma renin activity and hypokalemic alkalosis failed to reveal overproduction of aldosterone or any other known steroid. There was an abnormal increase in the fraction of unconjugated urinary steroids. Analysis of this fraction following the administration of labeled cortisol revealed that it was largely composed of dihydro metabolites reduced either at 4, 5 or at C-20 and that the 4,5-dihydro fraction contained an abnormal increase in 5.alpha.- relative to 5.beta.-metabolites. There was no absolute defect in the complete reduction of ring A to form tetrahydro derivatives. These findings and observations by Marver and Edelman that 5.alpha.-dihydrocortisol may be an effective mineralocorticoid, suggest the possibility of an etiologic relationship between the metabolic abnormality and the patient''s hypertensive disorder.