Metabolic Studies with Adrenocorticotropin in Cushing's Syndrome and in Virilism

Abstract

Balance studies during treatment with 50 mg. of ACTH daily were made on 2 female patients, 1 with Cushing''s syndrome due to bilateral adrenal cortical hyperplasia, and 1 with a masculinizing syndrome associated with diffuse luteinization of the ovaries. In both there occurred a significant increase in the daily urinary excretion of the 17-ketosteroids and the 11-oxygenated steroids. Neither showed an appreciable elevation in the fasting blood sugar level, or glycosuria. In both there occurred a leukocytosis in the peripheral blood and a reduction in the absolute number of eosinophils, although the increase in the total white cell count was less in the patient with the virilizing syndrome than in the patient with the Cushing''s syndrome. The patient with Cushing''s syndrome showed a marked decrease in the urinary excretion of K. The patient with the virilizing syndrome showed no alteration in the urinary excretion of Na and chloride and a slight K diuresis. The most striking change in the patient with Cushing''s syndrome occurred in relation to Ca balance. During the admn. of ACTH, there occurred only a slight increase in the urinary excretion but a marked inorease in the fecal excretion of Ca. The fact that the total Ca excretion was considerably in excess of the Ca intake showed that this was not just a reflection of decreased absorption of Ca. P behaved in a manner similar to Ca. The patient with virilization, on the other hand, showed only a slight increase in the fecal excretion of Ca and P after the admn. of ACTH. In both patients there occurred a slightly negative N balance during the period of treatment.