EFFECT OF PREDNISONE ON ADRENAL RESPONSIVENESS TO CORTICOTROPIN IN NORMAL SUBJECTS AND IN PATIENTS WITH TREATED AND UNTREATED CUSHING'S SYNDROME

Abstract

A study of the adrenocortical response to the injection of corticotropin before and following the daily oral administration of 40 mg. of prednisone for seven or more days has been made in 13 normal subjects, in 2 patients with active untreated non-tumorous Cushing''s syndrome, and in 3 patients with partial remission and in 4 patients with complete remission of the disease following therapy. The level of plasma 17-hydroxycorticoids was used as the index of adrenocortical response. In the subjects without evidence of adrenocortical hyperfunction, a significant suppression of the adrenocortical response to corticotropin was uniformly noted following the administration of prednisone. In the 2 patients with active, untreated Cushing''s syndrome due to bilateral adrenocortical hyperfunction there was no suppression of the adrenocortical response to corticotropin under the conditions of the prednisone suppression test. Studies conducted in the 7 cases of non-tumorous Cushing''s syndrome, in partial or in complete clinical and laboratory remission following irradiation of the pituitary, alone or combined with unilateral adrenalectomy, revealed the following: In 1 case of partial remission and 2 cases of complete remission, normal suppression of the adrenocortical response to corticotropin followed the administration of prednisone. In 2 cases of partial remission and in 2 cases of complete remission this suppression did not occur.