STEROID EXCRETION AND PLASMA CORTISOL IN 41 CASES OF CUSHING'S SYNDROME

Abstract

Urinary excretion of 17-hydroxycorticosteroids (17-OHCS) and of Porter-Silber chromo-gens as well as plasma cortisol at different times of fee day were measured repeatedly in 41 cases of Cushing''s syndrome and fee results were compared wife similar data from 55 non Cushing patients suffering from obesity, hypertension and other symptoms often associated wife Cushing''s syndrome. The Cushing patients showed a marked variation in steroid output and in many cases fee excretion was within fee control range during one or several days. In only 4 of all patients, however, did fee mean excretion of 17-OHCS overlap wife that found in fee control material. There was a marked overlapping between fee Cushing and fee non Cushing patients wife respect to plasma cortisol. At midnight, however, most Cushing patients (34/36) at repeated determinations snowed one or several figures higher than those of fee control material. In fee present material there was a marked overlapping between fee Cushing (15 cases) and fee non Cushing patients (14 cases) wife respect to fee increase in steroid excretion after intravenously administered corticotrophin (ACTH). In 14 cases of Cushing''s syndrome due to hyperplasia the administration of metapyron caused an increase in steroid excretion. One such case failed to react to metapyron as did 3 cases of cortisol producing tumors.