Further studies on the treatment of congenital adrenal hyperplasia with cortisone: Ii. the effects of cortisone on sexual and somatic development, with an hypothesis concerning the mechanism of feminization

IN a previous paper (1) we have reported the results of cortisone therapy in a series of 8 patients with congenital adrenal hyperplasia, who were treated for periods varying from ten days to five months. Two of these patients have now been treated continuously for seventeen months, and 1 for fifteen months. Four of the series, who were treated for relatively short periods, and 4 new patients have subsequently begun continuous therapy. The present report deals with these 11 patients who now have received cortisone continuously for periods of from five to seventeenmonths. Studies comparing the minimal doses of oral and of intramuscular cortisone-necessary to maintain adrenal suppression, as determined by the excretion of 17-ketosteroids, are presented in another communication (2). This paper is concerned with the clinical effects of cortisone therapy, particularly the effects on sexual and somatic development. For the purpose of discussion, the patients are divided on the basis of their age and sex into three groups.