title: Androstenedione aromatization as a cause of gynecomastia in 11beta-hydroxylase and 21-hydroxylase deficiencies.
abstract: OBJECTIVE
  To report two cases of gynecomastia that occurred in boys with 11beta-hydroxylase and 21-hydroxylase deficiency.
  
  
  METHODS
  We describe the physical findings and summarize the laboratory evaluation and treatment of two cases encountered in our medical practice.
  
  
  RESULTS
  Both of our patients (a 4-year-old boy and a 17-year-old boy) had extreme virilization and gynecomastia; on laboratory assessment, androstenedione and estrogen levels were high. Treatment with hydrocortisone was recommended.
  
  
  CONCLUSIONS
  Peripheral conversion of adrenal androgen to estrogen likely caused the feminizing syndrome in these patients.
authors.affiliation: Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma 73190, USA.
authors.forename: P R
authors.initials: PR
authors.lastname: Blackett MD
authors.forename: D A
authors.initials: DA
authors.lastname: Freeman MD