Recurrent severe hyperandrogenism during pregnancy: a case report.

[aromatase deficiency]

This report describes the case of a 28 year old woman with virilisation occurring in two successive pregnancies . Recurrent maternal virilisation is rare (seven previous reports ) and this case is unique in its severity . Differential diagnoses include ovarian disease and fetal aromatase deficiency . New techniques to exclude a fetal cause were used in this case . This patient presented during the third trimester of her first pregnancy with rapid onset of hirsuitism , increased musculature , and deepening voice . A blood hormone profile revealed significant hyperandrogenism (testosterone , 72 .4 nmol /litre ; normal range , 0 .5 -3 .0 ). She delivered a normal boy and maternal androgen concentrations returned rapidly to normal (testosterone , 0 .8 nmol /litre ). She presented two years later , during her second pregnancy , with similar symptoms and biochemistry (testosterone , 47 .5 nmol /litre ). Again , she delivered a healthy normal boy and androgens returned immediately to normal (serum testosterone , 2 .0 nmol /litre ). Ultrasonography revealed no evidence of ovarian (or adrenal ) masses in either pregnancy . Umbilical cord venous blood sampling and placental assays revealed no evidence of fetal aromatase deficiency . Recurrent hyperandrogenism during pregnancy is rare . Ovarian luteoma rarely recurs and hyperreactio luteinalis does not lead to such pronounced androgen concentrations . Therefore , this patient has a unique ovarian condition that could be harmful to offspring and mother .

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Diseases presenting "hyperreactio luteinalis does not lead to such pronounced androgen concentrations" symptom

aromatase deficiency

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