Transient adrenogenital syndrome due to exposure to danazol in utero
M. Castro-Magana, T. Cheruvanky, P. J. Collipp, Z. Ghavami-Maibodi, M. Angulo and C. Stewart
We describe a premature female infant exposed in utero to danazol during
the first trimester of pregnancy. She was first observed in the newborn
period with marked degree virilization and clinical findings suggestive of
salt-losing congenital adrenal hyperplasia. This was supported by the high
plasma levels of 17 alpha-hydroxyprogesterone and adrenocorticotropic
hormone and low plasma cortisol level. Levels of testosterone,
androstenedione, 11-deoxycortisol, and renin were also elevated. An
excessive increase in the levels of 17 alpha-hydroxyprogesterone and
11-deoxycortisol to corticotropin administration associated with impaired
increase in plasma cortisol level strongly suggests a partial block in the
21-hydroxylation of 17 alpha-hydroxyprogesterone. However, the high levels
of 11-deoxycortisol also suggest a block of the steroid 11
beta-monooxygenase. A year later she was found to have normal basal levels
of the adrenal steroids and normal response to corticotropin
administration, pointing out the transitory nature of these abnormalities.
It may be hypothesized that danazol produced a transitory block of the
steroid 21- and 11 beta-monooxygenases in this child.
