Glucocorticoid Therapy in a Case of Adrenogenital Syndrome:—Changes in Vaginal Cytology and their Relation to Hormon Transition in Urine—

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A case of 21-OH-lase deficiency non-salt losing type of congenital adrenal hyperplasia was diagnosed on the basis of endocrinological and other examinations.Clitoridectomy was followed by glucocorticoid therapy, of which effect was evaluated by changes of the level of urinary 17-KS. Having some decrease of clinical symptoms and complete recovery of sexual function, the patient eventually married and became pregnant.Vaginal smears taken before and periodically during the entire course of treatment sensitively reflected to alterations in the hormonal state. The androgen effect in vaginal cytology gradually disappeared with the treatment, replaced by estrinization. At the time of menarche, the vaginal smears showed normal female ones. Although ovulatory menstruation was induced, the cytology showed incomplete maturation unlike that in normal menstrual cycle. The maturation index closely coincided with changes in the urinary 17-KS and 17-OHCS levels.
近畿産科婦人科学会の論文