Significance of 3alpha, 17 alpha-dihydroxy-5beta-pregnane-20-one in the diagnosis of congenital adrenal hyperplasia.

The 3alpha-17alpha-dihydroxy-5beta-pregnane-20-one (17-hydroxy-pregnanolone) excretion was found by gas chromatography to be as high as the pregnanetriol in urine of 4 virilising CAH female and 2 male patients. According to our results the significance of the determination of 17-hydroxy-pregnanolone is equal to that of the pregnanetriol in the diagnosis of adrenal hyperplasia. As the 17-hydroxy-pregnanolone is demonstrable after mild acid hydrolysis, too, it can be applied independently from the pregnanetriol determination. In five out of the six patients we found the excretion of the pregnanediol to be high, too. Its value reached, irrespective of sex, the characteristic quantity of the woman's luteal phase, so it undoubtedly originated from the adrenal cortex. We dealt shortly with the explanation of high pregnanediol excretion.