THE EFFECT OF ADRENOCORTICOTROPIC HORMONE IN PANHYPOPITUITARISM 1

Abstract

The effects of ACTH (Armour) in doses ranging from 10 to 100 mg. daily were observed in 3 patients with panhypopituitarism. Metabolic balances of N, Ca, P, Na, K, and the urinary excretion of Cl, corticoids, and 17-ketosteroids are shown. ACTH produced (1) loss of N without commensurate loss of P and K; (2) loss of Ca; (3) retention of Na and Cl in extracellular fluid; (4) transient loss of K, which was apparently replaced by Na in intracellular fluid; (5) rise in urinary corticoid excretion; (6) rise in 17-ketosteroid excretion in one patient who still produced luteinizing hormone, but not in the other 2 patients. The effects of Armour ACTH were compared with those of pitressin and prolactin and with those of Li and Evans'' ACTH. Pitressin produced a loss of Ca, and a transient loss of Na and Cl; prolactin had no effect; ACTH (Li and Evans) produced all the effects of ACTH (Armour). The effects of ACTH were compared with those of desoxycorticosterone glycoside (DOCG). DOCG had an effect on K, Na, and Cl similar to that of ACTH, but the effects on K were less. The effects of ACTH could all be due to the release of "sugar" hormone; whether the rise in 17-ketos-teroids is to be so interpreted remains doubtful.