EFFECTS OF ADRENOCORTICOTROPIC HORMONE IN PNEUMONIA: CLINICAL, BACTERIOLOGICAL AND SEROLOGICAL STUDIES

Abstract

3 patients with pneumonia due to types 8, 2 and 1, respectively, and 2 with primary atypical pneumonia, were treated with ACTH. Defervescence and relief from symptoms and signs of toxemia occurred promptly in all cases. In 3 instances the patients remained asymptomatic and afebrile despite the persistance of bacteremia in one and the continued production of rusty sputum in another. One patient with pneumococcal pneumonia experienced an exacerbation of symptoms while receiving ACTH, with remission when the dose was increased. This patient had an extension of his pulmonary lesion and later developed empyema. One patient with viral pneumonia had a similar exacerbation of symptoms while receiving the hormone, with prompt relief from all spmptoms except cough when the dose of ACTH was increased, but with return of fever and malaise after ACTH was withdrawn. No evidence was obtained of any bactericidal action exerted by adrenal steroids. Antipneumococcal antibodies and cold agglutinins appeared at the anticipated time, with no evidence of acceleration or delay in their production. Eosinophiles were uniformly absent in all cases during the acute stages of the illness and returned either after the dose of ACTH was reduced, or, as in one case, when the patient developed tolerance to the admd. dose of the hormone and "escaped" from its effects. Clearing of the pulmonary lesions may have been accelerated in one patient and delayed in another but in the remaining 3 patients resolution of the pneumonic process seemed unchanged. All the patients manifested euphoria and a sense of well-being at some time while they were receiving the drug. 2 developed glycosuria, 2 developed facial edema and all demonstrated some degree of bradycardia but none showed any significant alterations of blood pressure or sedimentation rate attributable to the ACTH.