Serum total testosterone levels in a patient with late onset 21-hydroxylase deficiency and a twin gestation.
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.
Mains
Lindsay M
LM
Department of Obstetrics and Gynecology, Ochsner Clinic Foundation, New Orleans, Louisiana, USA.
Lathi
Ruth B
RB
Burney
Richard O
RO
Dahan
Michael H
MH
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
D013739:Testosterone; D013255:Steroid 21-Hydroxylase