Apparent Cortisone Reductase Deficiency: A Rare Cause of Hyperandrogenemia and Hypercortisolism

    January 2000 in “ Hormone Research in Paediatrics
    Anna Biason‐Lauber, Stephan L. Suter, Cedric Shackleton, M. Zachmann
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    Studysummary In this case study, a 55-year-old woman with androgenetic alopecia was ultimately diagnosed with hepatic cortisone reductase deficiency after initially suspected 21-hydroxylase deficiency was ruled out. Our plain-language summary of this paper — not a Tressless recommendation.
    A 55-year-old woman with androgenetic alopecia and a history of sterility was initially suspected to have 21-hydroxylase deficiency but was later found to have cortisone reductase deficiency, a rare condition affecting hepatic 11β-hydroxysteroid dehydrogenase (11β-HSD1). Despite elevated 17-OH-progesterone and testosterone levels, urinary steroid analysis and abdominal CT revealed bilateral adrenal hyperplasia and ovarian masses, leading to a diagnosis of cystic teratomas. Post-surgery, a decreased tetrahydrocortisol/tetrahydrocortisone ratio and elevated plasma cortisol confirmed cortisone reductase deficiency. This case highlighted the need for awareness of this rare condition in hyperandrogenic women, as it may be overlooked in favor of more common diagnoses.
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