HYPOGONADOTROPIC EUNUCHOIDISM: REPORT OF CASE WITH FAILURE TO RESPOND TO CHORIONIC GONADOTROPIC HORMONE DUE TO ANTIHORMONES

THE therapeutic efficacy of most of the available gonadotropic hormone preparations is limited by the rapid development of neutralizing substances generally termed antihormones. Pregnant mare's serum is particularly prone to call forth the development of these antihormones, thereby restricting the possible usefulness of this therapeutic agent to brief periods. On the other hand, there are available preparations of the chorionic gonadotropic hormone from human pregnancy urine which have appeared to be singularly free of this complicating reaction in man. However, it has been possible to produce neutralizing substances against this human chorionic gonadotropic hormone in various species of animals. This subject has been reviewed by Leathern (5) and Thompson (8). Despite the lack of demonstrable titers of antihormone against chorionic gonadotropic hormone in man, speculation about its existence has been extensive. A pregnancy test based on the concept that in women antihormones would regularly develop against their own chorionic gonadotropic hormone was proposed (2) but has proved unreliable (3). Furthermore, Leathern and Rakoff (6) failed to find any evidence of such antihormones in a group of postpartum women carefully studied. Fraser and coworkers (1) in Albright's group have suggested that antibodies developed to chorionic gonadotropin from human pregnancy urine, in two patients with hypogonadotropic eunuchoidism (Negative FSH) who had previously been treated with this substance. This suggestion was based upon the observation that these patients failed to respond to administration of this material with an increased output of urinary 17-ketosteroids. No studies for such antihormones were reported.