Plasma Immunoassayable ACTH Levels during and after Hydrocortisone Infusion in Patients with Cushing's Disease

Hashimoto, Kozo; Takahara, Jiro; Hosogi, Hidemi; Yunoki, Sho; Ofuji, Tadashi

doi:10.1507/endocrj1954.23.243

Cited by 6 publications

(1 citation statement)

References 3 publications

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“…A transient stimulation of ACTH during Cortisol infusion in some patients bilaterally adrenalectomized for Cushing's disease was observed by Berson and Yalow (1968) and Hashimoto, Takahara, Hosogi, Yunoki and Ofuji (1976). However, in the case described by Berson and Yalow (1968), in the test performed for the second time, a decrease in plasma ACTH during cortisone i.v.…”

Section: Discussionmentioning

confidence: 95%

Effect of Hydrocortisone on ACTH, Growth Hormone, Insulin and Glucose in the Blood of Bilaterally Adrenalectomized Patients

Kasperlik-Załuska¹,

Migdalska²,

Wilczyńska³

et al. 1980

Horm Metab Res

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This study is aimed at elucidating the mechanism of paradoxical rise in plasma ACTH levels in response to glucocorticoids, observed by several authors in bilaterally adrenalectomized patients with Cushing's disease. Six control subjects and fourteen patients bilaterally adrenalectomized for Cushing's disease were given a dose of 200 mg hydrocortisone sodium succinate by 3-5 mm i.v. injection. Plasma ACTH (in 6 patients), serum cortisol, growth hormone (GH) and insulin and blood glucose levels were estimated at 0, 30, 60, 90, and 120 minutes. The administration of hydrocortisone significantly suppressed plasma ACTH levels only at 60 min. In one case a slight rise in ACTH level during the test was observed. A significant fall in blood glucose levels was found only in the adrenalectomized patients. No significant changes in serum insulin and GH levels were noted. The possible mechanisms are discussed, especially the potential role of transient glucose deficiency in the pathophysiology of plasma ACTH increase in response to hydrocortisone in the bilaterally adrenalectomized patients.

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Section: Discussionmentioning

confidence: 95%

Effect of Hydrocortisone on ACTH, Growth Hormone, Insulin and Glucose in the Blood of Bilaterally Adrenalectomized Patients

Kasperlik-Załuska¹,

Migdalska²,

Wilczyńska³

et al. 1980

Horm Metab Res

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Paradoxical ACTH Response to Glucocorticoids in Cushing's Disease

Fehm¹,

Voigt²,

Lang³

et al. 1977

N Engl J Med

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To define further the defect in the steroid feedback mechanism in Cushing's disease, we studied the acute effects of intravenous administration of glucorticoids on plasma ACTH levels in seven patients with this disease after total adrenalectomy. In seven other patients with hypoadrenocorticism ACTH was readily suppressed; a significant decrease (72.5+/-5 per cent, mean +/- S.E.M., P less than 0.002) occurred within 15 minutes of the start of an infusion of 50 mg per hour of cortisol. In contrast, in the seven adrenalectomized patients with Cushing's disease, cortisol induced a transient paradoxical rise in ACTH levels, with a maximum at 15 minutes (347+/-99 per cent,, P less than 0.05). A similar ACTH response was observed with dexamethasone. Cushing's disease is characterized by a paradoxical transient rise in ACTH after glucocorticoid administration. This effect was more pronounced in adrenalectomized than in nonadrenalectomized patients.

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Small-Cell Carcinoma with Ectopic ACTH Secretion

1981

N Engl J Med

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Plasma Immunoassayable ACTH Levels during and after Hydrocortisone Infusion in Patients with Cushing's Disease

Cited by 6 publications

References 3 publications

Effect of Hydrocortisone on ACTH, Growth Hormone, Insulin and Glucose in the Blood of Bilaterally Adrenalectomized Patients

Effect of Hydrocortisone on ACTH, Growth Hormone, Insulin and Glucose in the Blood of Bilaterally Adrenalectomized Patients

Paradoxical ACTH Response to Glucocorticoids in Cushing's Disease

Small-Cell Carcinoma with Ectopic ACTH Secretion

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