In adult male rats the effect of a subchronic treatment with trilostane, a new, orally active, competitive inhibitor of 3 beta-hydroxysteroid dehydrogenase, on adrenal steroid production and morphology was studied. Rats were treated with 150 mg or 300 mg trilostane/kg/day for 7 or 14 days and with 150 mg trilostane/kg/day for 10 days in combination with 75 mg propranolol/kg/day or 1 mg indomethacin/kg/day. Trilostane leads to a dose-dependent increase in adrenal weight and to a rather uniform increase in nuclear volumes of zona glomerulosa and zona fasciculata cells. The basal secretion of aldosterone and corticosterone is not significantly altered. Trilostane increases the excretion of sodium and potassium in urine. The stimulating effect of trilostane on plasma renin activity and the adrenal enlargement are not inhibited by propranolol or indomethacin. We conclude that trilostane induces latent adrenal insufficiency. Increased renin and ACTH maintain normal basal steroid levels, and might impair the therapeutic effectiveness of trilostane.

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109 women with hirsutism were investigated (102 with idiopathic hirsutism, four with Stein-Leventhal syndrome, one each with adrenal adenoma, adrenal carcinoma and hilus-cell tumour). Levels of testosterone, dihydrotestosterone, androstenediol and dehydroepiandrosterone were measured, usually in the course of a combined adrenal-ovarian stimulation-suppression test. Measuring several plasma androgens made it possible to distinguish idiopathic hirsutism from other endocrine diseases with hirsutism. Mean plasma testosterone level in idiopathic hirsutism was not significantly different from that in healthy women. Elevated testosterone and(or) dihydrotestosterone levels were found in only 22 of 102 women. There was a marked increase in plasma testosterone after HCG injection in the patient with Stein-Leventhal syndrome. Androstenediol and dehydroepiandrosterone were both important in the diagnosis of autonomous adrenal steroid secretion.

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