Appraisal of Adrenocortical Hyperfunction: Patients with Cushing's Syndrome or “Non-endocrine” Tumors

Brooks, R. V.; Dupré, J.; Gogate, Anagha; Mills, Ivor H.; Prunty, F. T. G.

doi:10.1210/jcem-23-8-725

Cited by 55 publications

(19 citation statements)

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“…The cortisol production rate (by the method of Brooks, Dupre, Gogate, Mills & Prunty, 1963) was 23 mg/day (normal range 7-30 mg/day).…”

Section: Case Reportmentioning

confidence: 94%

Metabolic Studies in a Patient With a Phaeochromocytoma Associated With Hypokalaemia and Hyperaldosteronism

Wilson¹,

Craig²,

Mills³

1973

Journal of Endocrinology

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A case of phaeochromocytoma with hypokalaemia, hyperaldosteronism, normal cortisol production and normal urinary corticosteroid excretion is described. Both \g=a\-adrenergic blockade and combined \g=a\and \g=b\ blockade resulted in marked antidiuresis with urinary sodium and potassium retention and a rise in plasma volume. Combined \g=a\and \g=b\ blockade led to some reduction in the high aldosterone production rate. The hypokalaemia was corrected by \g=a\-adrenergic blockade. After operative removal of the tumour the aldosterone production rate was normal.The marked reduction in urinary sodium excretion in response to \ g = a \ \ x = r e q -\ adrenergic blockade, if reproducible in other cases of phaeochromocytoma, might be a useful test for the presence of a phaeochromocytoma.

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“…The cortisol production rate (by the method of Brooks, Dupre, Gogate, Mills & Prunty, 1963) was 23 mg/day (normal range 7-30 mg/day).…”

Section: Case Reportmentioning

confidence: 94%

Metabolic Studies in a Patient With a Phaeochromocytoma Associated With Hypokalaemia and Hyperaldosteronism

Wilson¹,

Craig²,

Mills³

1973

Journal of Endocrinology

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“…Determination of resting plasma and urinary 17-hydroxycorticoid levels are also of only limited use (Brooks, Dupré, Gogate, Mills & Prunty, 1963), and it is consequently necessary to employ various ' dynamic ' tests to confirm the diagnosis. Adrenocortical suppression tests are widely used in this respect, and depend on the finding that pituitary-adrenal function is less easily depressed by exogenous glucocorticoids in patients with Cushing's syndrome than in healthy subjects.…”

Section: Introductionmentioning

confidence: 99%

Oral and Intravenous Suppression Tests in the Diagnosis of Cushing's Syndrome

James¹,

Landon²,

Wynn³

1965

Journal of Endocrinology

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Adrenocortical suppression tests, based on the fall in urinary 17-hydroxy\x=req-\ corticosteroid excretion during the oral administration of dexamethasone, were found to be of value in the diagnosis of Cushing's syndrome, but less useful in differentiating bilateral adrenal hyperplasia from adrenal tumour. Such tests have the disadvantage of requiring accurate urine collections and of taking several days to perform. A test is described, based on the decrease in plasma cortisol concentration during i.v. infusion of dexamethasone at a rate of 1 mg./hr. The results obtained in 12 patients with Cushing's syndrome and bilateral adrenal hyperplasia differed from those found in control subjects in that there was a delay between the start of the infusion and the fall of plasma cortisol, and the rate of fall was less rapid. The values found after 180 min., expressed either as \g=m\g./100 ml. or as a percentage of the resting level, differed significantly (P < 0\m=.\001) in the two groups. The test proved valuable as an aid to the diagnosis of Cushing's syndrome, was easy to perform, and could be completed in 3 hr.In some patients with Cushing's syndrome, the administration of synthetic glucocorticoids appeared to result in an increased urinary steroid excretion. A transient increase in plasma cortisol levels was also observed in some of these patients during the early period of dexamethasone infusion. It is thought that this finding reflects an alteration in steroid metabolism induced by dexamethasone and fluorocortisol.

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“…The majority of our patients with adrenocortical tumours showed a clear response to ACTH. Though such findings are generally considered to be exceptions, there are many authors who have described similar results [8,14,17,30,37,43,44,54,56,70,77,81,100,105,111,112,118,132]. Only in one case of adrenocortical carcinoma we found no clear-cut difference before (28.8 /tg/100 ml) and after ACTH (27.4/tg/100 ml).…”

Section: (B) Adrenocortical Hyperfunctionmentioning

confidence: 51%

Adrenocortical Stimulation Tests with ACTH: Developments and Changes of a Diagnostic Procedure

Knappe¹

1971

Horm Res Paediatr

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Stimulation tests with ACTH have undergone various modifications due to the advent of different methods for an assessment of adrenocortical function. An attempt was made to review the manifold diagnostic procedures and to compare them with the experience obtained from an intravenous 1-hour test with fluorometric determination of plasma 11-hydroxycorticosteroids. The latter procedure represents the most simple reliable method being widely adequate to the requirements of clinical practice including outpatient performance. The results of the 1-hour ACTH test in adrenocortical diseases as well as in other clinical conditions are described.

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Appraisal of Adrenocortical Hyperfunction: Patients with Cushing's Syndrome or “Non-endocrine” Tumors

Cited by 55 publications

References 0 publications

Metabolic Studies in a Patient With a Phaeochromocytoma Associated With Hypokalaemia and Hyperaldosteronism

Metabolic Studies in a Patient With a Phaeochromocytoma Associated With Hypokalaemia and Hyperaldosteronism

Oral and Intravenous Suppression Tests in the Diagnosis of Cushing's Syndrome

Adrenocortical Stimulation Tests with ACTH: Developments and Changes of a Diagnostic Procedure

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