STUDIES IN PATIENTS WITH ADRENOCORTICAL HYPERFUNCTION. II. CORTICOSTEROID EXCRETION PATTERNS*

Abstract

The α-ketolic and α,β-unsaturated corticosteroids excreted in the urine were paper-chromatographically separated into the individual compounds. Scanning patterns of these steroids are presented as they occurred in healthy subjects and in 10 patients with adrenocortical hyperfunction. In the urine of 2 patients with an adrenal virilizing syndrome there were small amounts of an unidentified material (compound X₃), but otherwise normal patterns. In the patients with Cushing's syndrome there was a general increase in all urinary α-ketolic steroids as compared to the normal subjects. The levels of cortisone, hydrocortisone and tetrahydrocortisone were particularly elevated. Theratio THF/THE, which is always 9 and X₁₁)were decreased. In adrenalectomized patients exogenous cortisone was metabolized to THE, THF, hydrocortisone and occasionally to small amounts of DHE. In an adrenalectomized patient who was given corticosterone, the metabolic products of this hormone observed in the urine were compounds THB, allo-THB, THA, 11-dehydrocorticosterone and unchanged corticosterone. Another adrenalectomized patient excreted less of the a-ketolic metabolites of exogenously administered cortisone after hypophysectomy than before.