EFFECT OF ACTH ON THE ADRENALS IN THE NEPHROTIC SYNDROME AND RHEUMATIC FEVER*

Abstract

The effects of ACTH on the adrenals of small groups of patients with the nephrotic syndrome due to chronic glomerulonephritis and with rheumatic fever are presented. Adrenals of control untreated patients with the nephrotic syndrome had a smaller average weight and a higher fat content than those of untreated patients who had rheumatic fever or leukemia. In the one nephrotic patient who died while being treated with ACTH, all 3 zones of the adrenal cortex showed a decrease in fat and an increase in zone thickness and cell size, the response of the zona glomerulosa being similar to that in leukemic patients treated with cortisone before receiving ACTH. Findings in patients with rheumatic fever support those in patients with leukemia, namely, that the zona fasciculate is more responsive to ACTH than is the zona reticularis, and that cortisone alters the morphologic response of the adrenal cortex to ACTH.