Steroid hormone concentrations in the peripheral blood and the adrenal veins were
measured in the basal state and after ACTH stimulation in 5 patients with idiopathic
hirsutism. The basal concentrations of the steroids in the adrenal veins of the patients
with idiopathic hirsutism were not significantly different from a control group of
5 patients catheterized for investigation of pheochromocytoma. Following ACTH stimulation,
the concentrations of the steroids in the adrenal veins were also not significantly
different in the hirsute and the control groups except for the concentrations of DHA
and DHAS which were higher in the patients with idiopathic hirsutism. 17-hydroxyprogesterone
(17-OHP) concentrations after ACTH stimulation were lower in the hirsute group compared
to the control population. It is concluded that patients with idiopathic hirsutism
have a defect in the biosynthesis of cortisol proximal to the action of the 11β- and
21-hydroxylase enzymes, deficiencies of which have been previously considered to be
the usual causes of hirsutism due to an adrenocortical abnormality. The lower 17-OHP
concentrations in the hirsute group can be explained on the basis of deficiency of
substrate for the action of the 17-hydroxylating enzyme, consequent to the postulated
deficiency of 3β-hydroxysteroid dehydrogenase.
Steroids
-
Adrenal Venous Effluent
-
Idiopathic Hirsutism
