Low E3 occurs on the presence of several other steroidogenic deficiency, such as steroidogenic acute regulatory protein deficiency, CYP17A1 deficiency, steroid sulfates deficiency, defects of placental aromatase, hypopituitarism, and Smith–Lemli–Opitz syndrome. This evidence concerns the gene CYP17A1 and hyperinsulinemic hypoglycemia, familial, 4.