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Autoantibody against Testosterone in a Woman with Hypergonadotropic Hypogonadism

Department of Obstetrics and Gynecology, University of Tokushima School of Medicine (A.K., M.K., M.I., T.A), 3–18-15 Kuramoto, Tokushima 770; and the Departments of Obstetrics and Gynecology (O.N.) and Urology (T.Y.), Miyoshi Prefectural Hospital, Ikeda 779, Japan

Address all correspondence and requests for reprints to: Akira Kuwahara, M.D., Ph.D., Department of Obstetrics and Gynecology, University of Tokushima School of Medicine, 3–18-15 Kuramoto, Tokushima 770, Japan.

We demonstrate that antitestosterone autoantibody is produced in a 24-yr-old woman with hypergonadotropic hypogonadism. The serum testosterone level measured by RIA was extremely elevated (5.80 ng/mL); after elution, serum testosterone had returned to a normal female value (0.21 ng/mL). The clinical features were suggestive of no androgen activity. Primary follicles were present in the patent’s ovary. After gonadotropin treatment, conception was achieved, and a normal female infant was delivered.

A gel filtration study showed that the testosterone-binding activity was eluted at the position of 150,000-kDa Ig. Scatchard analysis revealed a low affinity antibody; the association constant was 0.034 x 10³ mol^-1, and the maximal binding capacity was 162 µmol/mL. An immunoprecipitation study using the chain-specific antibodies showed that the antitestosterone autoantibody belonged to -type IgG. This subject is the first reported case with an endocrine disorder who possessed autoantibodies against testosterone.