Treatment of Simmonds' Disease

Abstract

The diagnosis in 5 patients was established on the basis of the clinical picture with confirmation by the insulin tolerance test, electrolyte studies and estimation of the 17-ketosteroids and gonadotrophins excreted in the urine. The pituitary pathology was thought to be chromophobe adenomata in 2 cases, postpartum necrosis in 2 and unknown in the other. All patients had had adrenal crises; in 3 the crises were severe. Two patients had spent most, of the time in bed and all were inactive. Four patients had been treated from 1-12 yrs. as cases of (primary) myxedema. Adrenal crises had been induced by the use of thyroid in each subject. Assays were made on each patient to determine the optimum amts. of testosterone and desoxycorticosterone necessary for implantation. Each patient changed from a vegetative organism to an active, energetic and happy individual. Particularly striking was the increase in strength which occurred. The blood pressure, wt.. basal metabolic rate and serum Na returned to normal and have remained there. Only a slight increase in the 17-ketosteroids of the urine occurred. No ill effects from the treatment were observed except slight hirsutism in one O patient.