Effect of o, p’-DDD on cortisol secretory pattern in cushing’s syndrome

Leon Hellman, Elliot D. Weitzman, Howard Roffwarg, David K. Fukushima, Koichiro Yoshida, Barnett Zumoff, T. F. Gallagher

Research output: Contribution to journalArticlepeer-review

9 Scopus citations

Abstract

The pattern of cortisol secretion was studied in a patient with Cushing’s syndrome before and during treatment with o, p’-DDD. Plasma samples were obtained every 20 min throughout the 24 hr day and analyzed for cortisol by competitive protein binding. It was found that the numbers of cortisol secretory episodes were roughly comparable in the treated and untreated state despite a 60 day interval between the studies. Under the influence of the drug the adrenals were producing cortisol almost constantly during the 24 hr day. This was proved for a 3 hr period in the early afternoon after a tracer amount of cortisol-4-14C was injected. The specific activity of the plasma cortisol diminished progressively at different rates even though the plasma cortisol concentration rose and fell during this time. It is concluded that the system: central nervous system-corticosteroid releasing factor-ACTH, was intact, hyperfunctioning and similarly programmed in both the treated and untreated stages of the disease. DDD damages the adrenals’ capacity for cortisol production although at this stage of treatment they were still capable of sensible production of cortisol. Treatment with the drug converted the cortisol secretory pattern from a well-defined series of peaks and valleys to an almost level pattern fluctuating about the lowest plasma concentration measured in the untreated state.

Original languageEnglish
Pages (from-to)227-230
Number of pages4
JournalJournal of Clinical Endocrinology and Metabolism
Volume31
Issue number2
DOIs
StatePublished - 1970
Externally publishedYes

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