Abstract It has been demonstrated that treatment with cortisone causes suppression of adrenocortical function.* Further studies have shown that this suppression may be reversed by the administration of corticotropin even though the maintenance dose of cortisone is continued.2 The patients in this group have been studied at approximately yearly intervals since the initiation of their continuous therapy with cortisone. An earlier examination was reported previously.2 The present study comprises the results of investigations which were made in 1953 and 1954 to determine whether the adrenal cortex would still respond to corticotropin and also to observe the effect of long-term therapy with cortisone on other physiologic functions. PROCEDURE The same regimen was used in both 1953 and 1954. The patients were hospitalized during the study, and their customary program of a regular diet without supplemental potassium was continued. Daily maintenance doses of cortisone were continued unchanged. Patients entered the hospital References 1. References 2, 5, 14, and 15. 2. ACTHAR, Armour brand of adrenocorticotropic hormone, lyophilized, equivalent to 25 mg. standard LA-1-A. 3. References 4, 16, and 17. 4. References 8 and 11. 5. References 8 and 11. 6. References 8 and 14. 7. References 3, 7, and 11. 8. Drekter, J.; Pearson, S.; Bartezak, E., and McGavack, T. H.: A Rapid Method for the Determination of Total Urinary 17-Ketosteriods , J. Clin. Endocrinol. 7:795-800, 1947.Crossref 9. Engleman, E. P.; Krupp, M. A.; Johnson, H. P.; Welsh, J. E.; Wrenn, H. T., and King, W. R.: Adrenocortical Function During Continuous Long-Term Therapy with Cortisone , A. M. A. Arch. Int. Med. 91:1-7, 1953.Crossref 10. Fraser, C. G.; Preuss, F. S., and Bigford, W. D.: Adrenal Atrophy and Irreversible Shock Associated with Cortisone Therapy , J. A. M. A. 149:1542-1543, 1952.Crossref 11. Fredrickson, D. S.; Forsham, P. H., and Thorn, G. W.: The Effect of Massive Cortisone Therapy on Measurements of Thyroid Function , J. Clin. Endocrinol. 12:541-553, 1952.Crossref 12. Ingle, D. J., and Kendall, E. C.: Atrophy of the Adrenal Cortex of the Rat Produced by the Administration of Large Amounts of Cortin , Science 86:245, 1937.Crossref 13. Koets, P.: The Urinary 17-Ketosteroids , Stanford M. Bull. 5:42-50, 1947. 14. Lewis, L.; Robinson, R. F.; Yee, S.; Hacker, L. A., and Eisen, G.: Fatal Adrenal Cortical Insufficiency Precipitated by Surgery During Prolonged Continuous Cortisone Treatment , Ann. Int. Med. 39:116-126, 1953.Crossref 15. O'Donnell, W. M.; Fajans, S. S., and Weinbaum, J. G.: Human Adrenal Cortex After Administration of ACTH and Cortisone: Morphologic Changes , A. M. A. Arch. Int. Med. 88:28-35, 1951.Crossref 16. Pilot, M. L.: Use of Base in Fluids for Counting Eosinophils: A Method for Staining Eosinophils , Am. J. Clin. Path. 20:870, 1950. 17. Porter, C. C., and Silber, R. H.: A Quantitative Color Reaction for Cortisone and Related 17, 21 Dihydroxy-20-Ketosteroids , J. Biol. Chem. 185: 201-207, 1950. 18. Solassa, R. M.; Bennett, W. A.; Keating, F. R., and Sprague, R. G.: Postoperative Adrenal Cortical Insufficiency: Occurrence in Patients Previously Treated with Cortisone , J. A. M. A. 152:1509-1515, 1953.Crossref 19. Schales, O., and Schales, S. S.: Simple and Accurate Method for Determination of Chloride in Biological Fluids , J. Biol. Chem. 140:879-884, 1941. 20. Schoenheimer, R., and Sperry, W. M.: Micromethod for Determination of Free and Combined Cholesterol , J. Biol. Chem. 106:745-760, 1934. 21. Sprague, R. G.; Power, M. H., and Mason, H. L.: Physiological Effects of Cortisone and Pituitary Adrenocorticotropic Hormone (ACTH) in Man , J. A. M. A. 144:1341-1347, 1950.Crossref 22. Sprague, R. G.: Cortisone and ACTH: A Review of Certain Physiologic Effects and Their Clinical Implications , Am. J. Med. 10:567-594, 1951.Crossref 23. Wolfson, W. Q.; Beirwaltes, W. H.; Robinson, W. D.; Duff, I. F.; Jones, J. R.; Knorpp, C. T.; Siemienski, J. S., and Eya, M.: Corticogenic Hypothyroidism: Its Incidence, Clinical Significance, and Management During Prolonged Treatment with ACTH or Cortisone, in Proceedings of the Second Clinical ACTH Conference, Edited by John R. Mote, Philadelphia, The Blakiston Company, 1951, Vol. 2. 24. Wolfson, W. Q.; Beierwaltes, W. H.; Robinson, W. D.; Duff, I. F.; Jones, J. R.; Knorpp, C. T., and Eya, M.: Corticogenic Hypothyroidism: Its Regular Occurrence and Clinical Significance During Prolonged ACTH or Cortisone Therapy , J. Lab. & Clin. Med. 36:1005-1006, 1950. 25. Scott, K. G.; Reavis, J, C.; Saunders, W. W., and White, W. E.: The Use of I131 Red Cell Plasma Ratio as a Measure of Thyroid Function , Proc. Soc. Exper. Biol. & Med. 76:592-595, 1951.
A.M.A. Archives of Internal Medicine – American Medical Association
Published: Mar 1, 1955