EFFECT OF ROENTGENOTHERAPY ON URINARY 17-KETOSTEROID EXCRETION IN ANKYLOSING SPONDYLARTHRITIS*

Abstract

FEW studies of urinary 17-ketosteroid excretion have been made in rheumatic disease. Fraser and co-workers (1) found diminished excretion in a 16-year-old female with rheumatoid arthritis. Chou and Wang (2) reported low values in rheumatic fever. In 7 males with rheumatic disease, Forbes and associates (3) found the average excretion to be 7.5 mg. in 24 hours, with a range of 2.7 to 11.5 mg., and in females an average of 4.5 mg. with a range of 1.2 to 7.8 mg. Low excretion is found in malnutrition, anemia, hypothyroidism, panhypopituitarism, Addison's disease, and chronic debilitating diseases (1, 2, 3, 4, 5), whereas high excretion occurs in carcinoma of the adrenal cortex, hyperplasia of the adrenals, masculinizing ovarian tumors, hirsutism of females and in Cushing's syndrome (1, 6,7). Although ankylosing spondylarthritis is a chronic debilitating disease accompanied by malnutrition, anemia, and pronounced muscle wasting in its advanced stage, we have found increased urinary 17-ketosteroid excretion in all of 13 males having this disease (8). Our study of 17-ketosteroid excretion has been extended and the results are reported in this paper. Since roentgenotherapy exerts a pronounced beneficial effect on the course of the disease in these patients (9, 10, 11, 12), giving relief of symptoms, abatement of objective physical findings, and improved well being even in advanced cases, observations were made to determine the effects of roentgenotherapy on 17-ketosteroid excretion during the course of such treatment. The cases studied comprised 31 males and 4 females. The majority were patients in the outpatient clinic of Stanford University Medical School; a few were private patients. Five males and one female were Army personnel provided by Major Potter, all of whom were examined by one of us (R.D.). Four were Navy personnel whose records and roentgenograms were made available to us by Commander Cuttle.