Elevated urinary testosterone and androstanediol in precocious adrenarche

Using a newly devised radioligand method for the simultaneous determination of urinary testosterone (T) and androstanediol (Adiol) nine girls with precocious adrenarche were evaluated. In the base-line state average urinary T excretion (1.29 mug/24 hr) and Adiol excretion (1.33 mug/24 hr) were significantly elevated when compared with 15 age-matched controls (0.3 and 0.33 mug/ 24 hr, respectively, P less than 0.001 for both). Adrenocorticotropic hormone (ACTH) infusion performed in five patients with precocious adrenarche produced at least a 50 greater than increase in urinary T excretion in all and a similar increase in Adiol excretion in four of five patients. Dexamethasone administration in the same five patients produced a 25 greater than fall in urinary T excretion in all and a comparable fall in Adiol in four.