title: Serum total testosterone levels in a patient with late onset 21-hydroxylase deficiency and a twin gestation.
abstract: OBJECTIVE
  To present serum androgen levels during pregnancy in a twin gestation complicated by maternal late onset 21-hydroxylase deficiency.
  
  
  METHODS
  Case report.
  
  
  METHODS
  University teaching hospital reproductive endocrinology and infertility practice.
  
  
  METHODS
  A 27-year-old with nonclassic 21-hydroxylase deficiency and infertility, twin female fetuses, and elevated androgens.
  
  
  METHODS
  Steroid replacement.
  
  
  METHODS
  Serum T and 17-hydroxyprogesterone (17-OHP) levels.
  
  
  RESULTS
  Elevated androgen levels persisted throughout pregnancy in spite of aggressive steroid replacement. However, twin girls were born without any evidence of virilization.
  
  
  CONCLUSIONS
  The changes associated with a twin gestation may result in excessive stimulation of androgens in mothers with nonclassic 21-hydroxylase deficiency. However, the increased placental aromatase provides protection.
authors.affiliation: Department of Obstetrics and Gynecology, Ochsner Clinic Foundation, New Orleans, Louisiana, USA.
authors.forename: Lindsay M
authors.initials: LM
authors.lastname: Mains
authors.forename: Ruth B
authors.initials: RB
authors.lastname: Lathi
authors.forename: Richard O
authors.initials: RO
authors.lastname: Burney
authors.forename: Michael H
authors.initials: MH
authors.lastname: Dahan
mesh_terms: D000312:Adrenal Hyperplasia, Congenital / Q000097:blood* / Q000201:enzymology / Q000235:genetics; D000328:Adult; D005260:Female; D006801:Humans; D011247:Pregnancy; D011272:Pregnancy, Multiple / Q000097:blood* / Q000235:genetics; D013255:Steroid 21-Hydroxylase / Q000097:blood* / Q000235:genetics; D013739:Testosterone / Q000097:blood*; D014427:Twins / Q000097:blood* / Q000235:genetics
chemical_list: D013739:Testosterone; D013255:Steroid 21-Hydroxylase