endocrine and metabolic disorders
Adrenal Virilism
Key Points
Adrenal virilism is due to an androgen-secreting adrenal tumor or to adrenal hyperplasia. Virilization is more noticeable in women; men may be infertile due to suppressed gonadal function. Urinary and plasma dehydroepiandrosterone (DHEA) and its sulfate (DHEAS) and often plasmatestosteroneare elevated. Dodexamethasonesuppression testing and adrenal imaging to look for androgen-producing adrenal tumors. Measure adrenal hormone intermediate metabolites and do adrenocorticotropic hormone (ACTH) stimulation testing to look for congenital adrenal hyperplasia. Hyperplasia is treated with corticosteroid therapy; tumors require adrenalectomy. 