QUALITATIVE DIFFERENCES IN URINARY 17-KETOSTEROID EXCRETION IN PATIENTS WITH CUSHING'S SYNDROME

Abstract

Using the chromatographic-colorimeter method the different fractions of urinary 17-ketosteroids (17-KS) were analyzed in 5 patients (2 with adrenal cortical adenoma, 3 with adrenal cortical hyperplasia). Two of the latter (1 male, 1 female) exhibited a high fraction III (3-beta-OH-17-KS) while 2 of the former (1 child, 1 female) had a low fraction HI. A 12-year-old girl with cortical hyperplasia had a low fraction HI assumed to be due to the absence of luteinizing hormone in the preadolescent. Two patients with adenoma and 2 with cortical hyperplasia had almost indentical quantities of fraction IV and V (3-alpha-OH-17-KS) and of the C11 oxygenated 17-KS. Both these steroids are assumed to be metabolites or by-products resulting from the excessive synthesis of C21 steroids. One adult male (cortical hyperplasia), however, had a low 3-alpha-OH-17-KS in relation both to C11 oxygenated steroids and 3-beta-OH-17-KS. No parallelism was observed between the amounts of 3-beta-OH-17-KS. Sex did not influence the qualitative composition in these cases. The differences observed agree with previously published findings of others. The clinical applications of these observations are discussed.