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Virilizing adrenal tumour mimicking congenital adrenal hyperplasia with P450c11 (11β-hydroxylase) deficiency

  • Endocrinology
  • Published:
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Abstract

In a girl aged 5 years with a virilizing adrenal adenoma the urinary and plasma steroid findings suggested the diagnosis of congenital adrenal hyperplasia due to P450c11 (11β-hydroxylase) deficiency. After removal of the tumour clinical signs receded and the hormonal values normalized. RNA analysis of the tumour tissue revealed low amounts of P450c11 mRNA which indicates that P450c11 deficiency of the adenoma caused the steroid abnormalities in this girl.

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Abbreviations

THS :

tetrahydro-S

DHA :

dehydroepiandrosterone

References

  1. Arnheim N (1979) Characterization of mouse ribosomal gene fragments purified by molecular cloning. Gene 7: 83–96

    Article  PubMed  Google Scholar 

  2. Chirgwin JM, Przybyla AE, MacDonald RJ, Rutter WJ (1979) Isolation of biologically active ribonucleic acid from sources enriched in ribonuclease. Biochemistry 18:5294–5299

    PubMed  Google Scholar 

  3. Chung B, Matteson KJ, Voutilainen R, Mohandas TK, Miller WL (1986) Human cholesterol side-chain cleavage enzyme, P450scc: cDNA cloning, assignment of the gene to chromosome 15, and expression in the placenta. Proc Natl Acad Sci USA 83: 8962–8966

    PubMed  Google Scholar 

  4. Chung B, Picado-Leonard J, Haniu M, Bienkowski M, Hall PF, Shively JE, Miller WL (1987) Cytochrome P450c17 (steroid 17α-hydroxylase/17,20-lyase): cloning of human adrenal and testis cDNAs indicates the same gene is expressed in both tissues. Proc Natl Acad Sci USA 84:407–411

    PubMed  Google Scholar 

  5. Curnow KM, Tusie-Luna M-T, Pascoe L, Natarajan R, Gu J-L, Nadler JL, White PC (1991) The product of the CYP11B2 gene is required for aldosterone biosynthesis in the human adrenal cortex. Mol Endocrinol 5: 1513–1522

    PubMed  Google Scholar 

  6. David R, August G, Gandy HM (1968) A virilising tumor with borderline elevation of urinary 17-ketosteroids. Pediatrics 42:139–148

    PubMed  Google Scholar 

  7. Degenhart HJ, Drop SLS, Hoogerbrugge J, Seters AP van, Vries HR de (1982) In vitro studies of enzymatic activities in human adrenal tumors. Horm Res 16:96–99

    PubMed  Google Scholar 

  8. Haji M, Ogo A, Ohashi M, Sekiya K, Takayanagi R, Takayama K, Kumazawa J, Nawata H (1990) Decreased levels of steroid 21-hydroxylase [P450c21] and its mRNA in an adrenocortical adenoma associated with 21-hydroxylase deficiency. Endocrinol Jpn 37:841–850

    PubMed  Google Scholar 

  9. Honour JW, Price DA, Taylor NF, Marsden HB, Grant DB (1984) Steroid biochemistry of virilising adrenal tumours in childhood. Eur J Pediatr 142: 165–169

    Article  PubMed  Google Scholar 

  10. Ilvesmäki V, Voutilainen R (1991) Interaction of phorbol ester and ACTH in the regulation of steroidogenic P450 genes in human fetal and adult adrenal cell cultures. Endocrinology 128: 1450–1458

    PubMed  Google Scholar 

  11. Lashansky G, Saenger P, Fishman K, Gautier T, Mayes D, Berg G, Di Martino-Nardi J and Reiter E (1991) Normative data for adrenal steroidogenesis in a healthy pediatric population: age-and sex-related changes after adrenocorticotropin stimulation. J Clin Endocrinol Metab 73:674–686

    PubMed  Google Scholar 

  12. Leinonen P, Ranta T, Siegberg R, Pelkonen R, Heikkilä P, Kahri A (1991) Testosterone-secreting virilizing adrenal adenoma with human chorionic gonadotrophin receptors and 21-hydroxylase deficiency. Clin Endocrinol 34:31–35

    Google Scholar 

  13. Lipsett MB, Wilson H (1962) Adrenocortical cancer. Steroid biosynthesis and metabolism evaluated by urinary metabolites. J Clin Endocrinol Metab 22:906–915

    PubMed  Google Scholar 

  14. Matteson KJ, Phillips III JA, Miller WL, Chung B, Orlando PJ, Frisch H, Ferrandez A, Burr IM (1987) P450XXI (steroid 21-hydroxylase) gene deletions are not found in family studies of congenital adrenal hyperplasia. Proc Natl Acad Sci USA 84:5858–5862

    PubMed  Google Scholar 

  15. McKenna TJ, O'Connell Y, Cunningham M, Culliton M (1990) Steroidogenesis in an estrogen-producing adrenal tumor in a young woman: Comparison with steroid profiles associated with cortisol- and androgen-producing tumors. J Clin Endocrinol Metab 70: 28–34

    PubMed  Google Scholar 

  16. Mornet E, Dupont J, Vitek A, White PC (1989) Characterization of two genes encoding human steroid 11β-hydroxylase (P-45011β). J Biol Chem 264:20961–20967

    PubMed  Google Scholar 

  17. Pang S, Becker D, Cotelingam J, Foley TP, Drash AL (1981) Adrenocortical tumor in a patient with congenital adrenal hyperplasia due to 21-hydroxylase deficiency. Pediatrics 68:242–246

    PubMed  Google Scholar 

  18. Shimshi M, Ross F, Goodmann A, Gabrilove JL (1992) Virilizing adrenocortical tumor superimposed on congenital adrenocortical hyperplasia. Am J Med 93:338–342

    Article  PubMed  Google Scholar 

  19. Solish SB, Goldsmith MA, Voutilainen R, Miller WL (1989) Molecular characterization of a Leydig cell tumor presenting as congenital adrenal hyperplasia. J Clin Endocrinol Metab 69: 1148–1152

    PubMed  Google Scholar 

  20. Sorgo W, Meyer D, Rodens K, Homoki J, Heinze E, Heymer B, Siebenmann R (1988) Testosterone-secreting adrenocortical tumor in a pubertal girl. Horm Res 30:217–223

    PubMed  Google Scholar 

  21. Touitou Y, Lecomte P, Auzéby A, Bogdan A, Besnier Y (1989) Evidence of 11β-hydroxylase deficiency in a patient with cortical adrenal adenoma. Horm Metab Res 21:272–274

    PubMed  Google Scholar 

  22. Völlmin JA (1971) High resolution gas chromatography of urinary steroids on glass capillary columns. Clin Chim Acta 34:207–214

    Article  PubMed  Google Scholar 

  23. Voutilainen R, Tapanainen J, Chung B, Matteson KJ, Miller WL (1986) Hormonal regulation of P450scc (20,22-desmolase) and P450c17 (17α-hydroxylase/17,20-lyase) in cultured human granulosa cells. J Clin Endocrinol Metab 63:202–207

    PubMed  Google Scholar 

  24. Voutilainen R, Ilvesmäki V, Miettinen PJ (1991) Low expression of 3β-hydroxy 5-ene steroid dehydrogenase gene in human fetal adrenals in vivo; Adrenocorticotropin and protein kinase C-dependent regulation in adrenocortical cultures. J Clin Endocrinol Metab 72:761–767

    PubMed  Google Scholar 

  25. Werder EA, Morger R, Fretz C, Diener PA, Zachmann M (1992) Unusual steroid pattern of a virilizing adreanl tumor mimicking congenital adrenal hyperplasia (11β-hydroxylase deficiency) (Abstract 121). Horm Res 37 [Suppl 4]:32

    PubMed  Google Scholar 

  26. West CD, Kumagai LF, Simons EL, Dominguez EL, Berlinger DL (1964) Adrenocortical carcinoma with feminization and hypertension associated with a defect in 11β-hydroxylation. J Clin Endocrinol Metab 24:567–579

    PubMed  Google Scholar 

  27. Wiedenfeld J, Shaeffer JM, Landau H, Schiller M, Zadik Z (1978) 11β-hydroxydehydroepiandrosterone in a case of virilising adrenal adenoma. Isolation from urine and mitochondrial conversion from dehydroepiandrosterone. J Clin Endocrinol Metab 47:102–104

    PubMed  Google Scholar 

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Werder, E.A., Voutilainen, R. & Zachmann, M. Virilizing adrenal tumour mimicking congenital adrenal hyperplasia with P450c11 (11β-hydroxylase) deficiency. Eur J Pediatr 153, 411–415 (1994). https://doi.org/10.1007/BF01983403

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  • DOI: https://doi.org/10.1007/BF01983403

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