EFFECTS OF CORTICOTROPIN ON BODY WATER AND ELECTROLYTES IN PATIENTS WITH RHEUMATIC DISEASE 1

Abstract

Four patients with rheumatic diseases were treated with corticotropin for periods ranging between 19 and 43 days. Two patients retained water intracellularly during the 1st week of treatment, and simultaneously showed a shift of extracellular water into the cells. The decrease in extracellular fluid volume was subsequently restored on further treatment. In 2 patients, intracellular water was decreased throughout therapy and a transient shift of cell water to the extracellular fluid was noted early in treatment. One of these patients developed a marked increase in extracellular fluid volume after 2 weeks of corticotropin. Total body solids decreased and then rose in 2 patients, and increased progressively in 2 patients. Na retention was induced in 3 patients as indicated by a rise in total body Na. All or most of this retained Na became part of the non-extracellular, electrolyte. In 2 of 3 patients there was retention of chloride mainly as non-extracellular chloride. In the 3d patient, changes in total body chloride were consistent with changes in extracellular fluid volume. Under the conditions of these studies, markedly different patterns of response to corticotropin were observed.