A method for measurement of total 17-OH, 21-methyl steroids in the urine and its application to clinical problems

A method for measuring the urinary levels of 17-OH, 21-methyl corticosteroids is proposed. The principle of the method involves the selective extraction of these compounds from β-glucuronidase hydrolyzed urines with carbon tetrachloride. The routine method for determination of 17-ketogenic steroids is then done on the CCl 4 extract. In the presence of significant amounts of 17-KGS, it is possible to distinguish the 17-OH 21-methyl steroids from 17-OH, 20, 21-ketols by performing the Porter-Silber reaction for the latter compounds. The normal levels of total 17-OH, 21-methyl corticosteroids were determined. Elevated levels of total 17-OH 21-methyl steroids were shown in congenital adrenal hyperplasia, and in adult onset virilizing adrenal hyperplasia. Responses to exogenous corticosteroid therapy are also shown. This method is attractive in that it employs the early steps of the routine clinical methods for determination of 17-OH corticosteroids (Porter-Silber chromogens), the modification being the extraction of the 17-OH 21-methyl sterods by CCl 4 prior to the methylene dichloride extraction for 17-OHCS. The extraction method is also useful in isolation studies of such steroids.