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February 1, 1964

Hormone Secretion in Klinefelter's Syndrome-Reply

JAMA. 1964;187(5):377. doi:10.1001/jama.1964.03060180063029

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I bow to Dr. Segre's comments. He is quite correct. The 17-ketosteroid excretion is a reflection of many precursors, only one of which is testosterone. In the reference given as a source for the statement in question, of 17 patients with chromatin-positive Klinefelter's syndrome, 12 had 17-ketosteroid excretions in the normal range, 3 had below normal, and 2 had above normal excretions. Undoubtedly, although androgens make up some proportion of this excretion, many other precursors are involved. It is interesting that testosterone is believed to originate in the Leydig cells (which are abundant in the small Klinefelter's testis), but nonandrogenic hormones apparently arise from the seminiferous tubules (which are dysgenetic and presumably poorly functioning in this syndrome).

What is truly needed is more complete determination of the precursors produced by the Klinefelte-'s patient, in an effort to learn what makes up the proportion not produced as testosterone, if this is

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