| Popis: |
C19 steroids were analysed by gas chromatography and mass spectrometry in the urine of a patient who developed virilizing luteoma during the 8th month of pregnancy. Thirty-nine C19 steroids were isolated. The structure of twenty-eight of them was established: sixteen 17-oxosteroids, five androstane-3,16,17-triol, three 5-androstene-3,17-diol, 5β-androstane-3α,17β-diol, 4-androstene-3α,17β-diol, 3α-hydroxy-5α-androst-16-ene, 16α,17β-dihydroxy-4-androsten-3-one, and 5-androstene-3β,16,17β-triol; two of the other catabolites were 5ξ-androstane-2ξ,3ξ,17ξ-triol and two 5-androstene-3ξ,15ξ,17ξ;-triol were also present. The total excretion of 17-oxosteroids amounted to 167 mg per day and some 90% was due to five metabolites: 3α-hydroxy-5α-androstan-17-one (95.6 mg), 3α-hydroxy-5β-androstan-17-one (35.6 mg), 3β-hydroxy-5-androsten-17-one (8.5 mg), 3α,16α-dihydroxy-5α-androstan-17-one (6.3 mg) and 3α,18-dihydroxy-5α-androstan-17-one (5.6 mg). Other principal metabolites induced: 4-androstene-3α,17β-diol, 5β-androstane-3α,17β-diol, 5α-androstane-3α,16α,17β-triol and 5β-androstane-3α,16α,17β-triol with respectively daily excretions of 8.9, 5.1, 2.85 and 2.4 mg and a total of 5-androstene-3β,17β-diol (4.6 mg/24h). These results confirmed the hyperproduction of 4-androsten-3,17-dione, 17β-hydroxy-4-androsten-3-one and 3β-hydroxy-5-androsten-17-one which were responsible for the maternal virilization syndrome. On the other hand the absence of any symptom of foetal virilization may be explained by the co-incidence of several factors, in particular the date of the appearance activity of strong androgens, the general metabolic activity of the patient and presumably the role of the placenta in the metabolism of the hormones. To determine precisely the role of luteal tissue in C19 steroids production we believe, that, in the future, intratumoral steroids have also to be analysed. |
