CLINICAL APPLICATION OF THE SIMPLIFIED SILBER-PORTER METHOD FOR DETERMINING PLASMA 17-HYDROXYCORTICOSTEROIDS*

Abstract

A slight modification of the Silber-Porter technique for measurement of free plasma 17,21-dihydroxy-20-ketosteroid levels is described which is simple enough to be used in clinical studies. Values in 50 normal subjects ranged from 4-32 [mu]g/100 ml plasma with a mean of 16 [plus or minus] 6.9. Values were normal in most patients with non-endocrine diseases and in patients with disorders of glands other than the adrenal cortex. Elevated values occurred in diabetic acidosis and the moribund state. Patients with renal insufficiency had normal or elevated levels of plasma 17-OH-CS in contrast to low urinary steroid excretion values sometimes found. Levels of plasma 17-OH-CS tended to be outside the normal range in diseases of the adrenal cortex. Levels were low in primary adrenocortical insufficiency (18 patients, range 0.21 [mu]g %); secondary adrenocortical insufficiency due to hypopituitarism (8 patients, range 0-12 [mu]g %); and congenital adrenal hyperplasia with virilism (9 patients, range 0.20 [mu]g %). High plasma 17-OH-CS levels occurred in Cushing''s syndrome (9 patients, range 29-107 [mu]g %), and also in the 3d trimester of pregnancy (9 patients, range 22-52 [mu]g %).