Endocrine Abstracts

A 30-year-old woman pakistani patient was admitted to king Abdulaziz University hospital in Jeddah, Saudi Arabia with history of severe abdominal pain, vomiting and hypotension. She was born with Ambiguous genitalia and operated at age 8 years. She has severe hirsutism, with score of 18 and virilization. There are no family history of congenital adrenal hyperplasia. Physical examination showed her height was 151 cm and weight 42 kg. For evolution of hirsutism and virilization. Endocrinological data showed heigh DHEA-S and urinary 17 KS levels were moderately increased, while plasma testosterone, androstenedione and urinary 17 OHCS levels were normal. CT the abdomen and pelvis were normal. The patient had increased plasma 17-hydroxypregnenolone and DHEA concentrations in response to ACTH. 17-hydroxypregnenolone is 6.2 ng/ml and increase up to 10.5 30 minute after ACTH stimulation. DHEA-S is 5.3 ng/ml and increase to 13.8 nm/ml after ACTH stimulation. She had increased ratios of 17-hydroxypregnenolone of DHEA to androstenedione. After administration of 2 mg dexamethasone twice daily, all glucocorticoid and androgen levels including their metabolites decreased, indicating that the excessive androgen was derived from the adrenal glands. BMD showed severe osteoporosis with T score – 3.5. Patient was treated with dexamethasone,1 mg twice daily, Densoumb 60 mg Im once every 6 month as well social and psychological support. The patient felt that hirsutism was improved; the shaving frequency decreased from twice a day to once a day and the texture of the hair became softer and less coarse.