Metabolic Changes Resulting From 90yt Irradiation of the Pituitary in a Patient With Cushing's Syndrome

Abstract

A detailed metabolic study has been made of a 48-year-old woman with Cushing's syndrome associated with presumed adrenocortical hyperplasia. The patient was shown to be secreting excessive amounts of cortisol. The urine contained low levels of aldosterone, but there was a hypokalaemic alkalosis. Plasma corticosterone was not raised.Destruction of the pituitary by insertion of 90Yt seeds produced clinical improvement and amelioration of hypertension. The adrenocortical activity promptly subsided to below normal levels. Negative nitrogen and calcium balances became positive, urine calcium fell and hyperglycaemia disappeared. The condition of hypokalaemic alkalosis was restored to normal and aldosterone excretion increased. The decline in thyroid activity was slower than that of adrenocortical activity. Calculation of the distribution of muscular and fatty tissue in the body showed that treatment produced an improvement. The significance of some of these changes is discussed.