Increased urinary and plasma etiocholanolone and related steroids in a boy with virilizing adrenal hyperplasia and periodic fever

Urticaria in association with etiocholanolone fever

A 17-year-old girl is reported with a history of recurrent febrile episodes during her menstrual bleeding accompanied by a generalised exanthem. Increased plasma levels of unbound etiocholanolone were noticed during the febrile attacks. Both the fever and the skin eruption could be suppressed by oral contraceptives.

Salt-losing syndrome in 2 infants with defective 18-dehydrogenation in aldosterone biosynthesis

Two infants presented with a salt-losing syndrome, the presenting features of which were subtle. One case appeared to be transient. Deficient production of aldosterone was shown by plasma renin activity and plasma aldosterone profile. Gas chromatography-mass spectrometry of urine indicated a defect in 18-dehydrogenation of 18-hydroxycorticosterone. Treatment with salt supplements and 9alpha-fludrocortisone reversed the salt-losing state and in one case treatment was later stopped. Although the disease may appear transient, the biochemical defect is persistent and for adequate growth a positive salt-balance is necessary.

Recurrent fever of unknown etiology: failure to demonstrate association between fever and plasma unconjugated etiocholanolone

A sensitive method for determination of plasma unconjugated etiocholanolone by double-isotope-derivative dilution has been described. The mean values for normal subjects was 0.038+/-0.003 (SEM) mug/100 ml.40 patients, 20 with familial Mediterranean fever and 20 with other diseases characterized by recurrent fever were studied. The over-all mean concentration of plasma unconjugated etiocholanolone for the patients (febrile or afebrile) was 0.101 +/-0.012 mug/100 ml, significantly above that of normals. Mean plasma values for the patients while they were febrile did not differ from the mean values when they were afebrile. It is suggested that the concentration of plasma unconjugated etiocholanolone is not related to fever in these patients.