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Massive Steroid Excretion and Hypocholesterolemia with an Adrenal Adenoma: Report of a Case

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▸Address reprint requests to Steven B. Leichter, M.D., Division of Metabolism, Department of Medicine, Washington University School of Medicine, St. Louis, MO 63110.

St. Louis, Missouri

Ann Intern Med. 1974;81(5):638-640. doi:10.7326/0003-4819-81-5-638
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A 48-year-old woman with mild hirsutism had extremely elevated urinary excretion of 17-ketosteroids (as high as 1555 mg per day). At operation, a large, benign adenoma was found. The case was unusual in that she had severe hypocholesterolemia that was first documented 2 years before surgery. Postoperatively, plasma cholesterol levels promptly returned to normal. It is proposed that the markedly elevated production of steroid substances by this tumor led to a massive diversion of plasma cholesterol, exceeding any compensatory increase in hepatic cholesterol synthesis. This consequence of steroid overproduction has hitherto been unrecognized.





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