URINARY 17 - KETOSTEROID CONJUGATES IN HIRSUTISM By PIERRE MAUVAIS - JARVIS AND ETIENNE - EMILE BAULIEU

The principal urinary 17-ketosteroids (17KS) were analyzed in 16 cases of hirsutism; their conjugated forms were separately cleaved, and the liberated 17KS were chromatographed and quantitated. Six were clinically classified as cases of Stein-Leventhal syndrome and the remaining 10 as "idiopathic hirsutism." 1 The following conditions were excluded a priori: adrenal and ovarian tumors, Cushing's disease, and congenital adrenal hyperplasia. Determination of total urinary 17KS in idiopathic hirsutism or in the Stein-Leventhal syndrome has not disclosed conclusive information regarding either the etiology or the pathologic physiology responsible for the appearance of hirsutism in these patients. On the other hand, fractionation of the urinary 17KS has revealed two types of urinary steroid abnormalities in hirsute patients. One abnormality is manifest primarily as an increase in urinary dehydroisoandrosterone 2 both before and after administration of ACTH (2). The second abnormality is an increased urinary level of androsterone and etiocholanolone. In the latter instance some authors have suggested that the adrenal is responsible for the precursors of the increased androsterone and etiocholanolone (3-7), although others have suggested an ovarian origin and still others could not discern the glandular origin of these steroids (8-10). A significant residual level of urinary 17KS after adrenal suppression following administration of