The excretion of steroids in urine and faeces was studied in an infant with infantile spasm with hypsarrhytmia. The analyses, which were carried out by gas-liquid chromatography and gas chromatography-mass spectrometry, were done before and after the infant was treated with excessive doses of ACTH. Prior to treatment the infant excreted less than 0.1 mg/24 h of individual steroids but after treatment the concentration in urine and faeces of several steroids increased 20-30 fold and the total excretion was about 12 mg/24 h both in urine and faeces. All the quantitatively predominant steroids excreted after ACTH treatment had a 3β-hydroxy-5-ene-structure: 3β,16α-dihydroxy-5-androsten-17-one, 3β,17β-dihydroxy-5-androsten-16-one, 5-pregnene-3β,20α-diol, 3β,16α-dihydroxy-5-pregnen-20-one, 3ξ,20ξ-dihydroxy-5-pregnen-16-one and 5-pregnene-3β,17α,20α-triol. 5-Pregnene-3β,20α-diol had an anticonvulsant activity when tested on newborn mice and the hypothesis is presented that the antiepileptic effects of ACTH in infants with hypsarrhytmia may be mediated via 3β-hydroxy-5-ene-steroids.
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