URINARY EXCRETION OF GONADOTROPINS IN CONGENITAL ADRENAL HYPERPLASIA

Four normal children and eight subjects with congenital adrenal hyperplasia (ranging in age from 4 to 29 years) were studied for their urinary excretion of steroids, follicle stimulating hormone (FSH), and luteinizing hormone (LH) under control conditions and during suppression with corticosteroids. In the normal children, urinary FSH and LH excretion was less than 0.5 and 0.24 I.U. per day, respectively, whereas in four of five children with congenital adrenal hyperplasia they were detectable and often of adult magnitude. Gonadotropin levels in the adult patients were more variable. Suppression of steroid output by corticosteroid therapy caused a fall of FSH in three of six patients. LH excretion was unchanged in five and rose in two. These findings suggest that the compensatory pituitary hyperactivity in congenital adrenal hyperplasia is not limited to the pituitary-adrenal mechanism but has repercussions in gonadotropin regulation as well.