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PLASMA ACTH AND CORTISOL PROFILES IN ADDISONIAN PATIENTS RECEIVING CONVENTIONAL SUBSTITUTION THERAPY
Author(s) -
SCOTT R. S.,
DONALD R. A.,
ESPINER E. A.
Publication year - 1978
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/j.1365-2265.1978.tb01516.x
Subject(s) - medicine , endocrinology , morning , hydrocortisone , cortisol awakening response , acth secretion , adrenocorticotropic hormone , mineralocorticoid , addison's disease , aldosterone , primary adrenal insufficiency , disease , hormone
SUMMARY Plasma ACTH and cortisol profiles were studied over 24 h in five Addisonian patients maintained in good health by conventional gluco‐ and mineralocorticoid treatment. Patients received their usual treatment (15–30 mg cortisol daily) in divided doses at 08.00 and 16.00 hours. Plasma cortisol concentrations differed from those of control subjects in being higher from 08.00 hours‐noon and 17.00–18.00 hours and were unmeasurable (>20 nmol/l) during the period of active cortisol secretion (03.00–08.00 hours) observed in normal subjects. Peak plasma ACTH levels (618‐>1600 ng/l) occurred at 08.00–09.00 hours in the Addisonian patients and were much greater than those seen in control subjects (60–220 ng/l). Despite this, plasma ACTH fell promptly within 3 h of the morning dose to less than 100 ng/l and levels were indistinguishable from those seen in normal subjects over the period 12.00–02.00 hours. These results show that there are substantial differences between treated Addisonian and control subjects in respect of plasma cortisol and ACTH concentrations. The findings may lead to a better understanding of ACTH‐cortisol relationships in disease states, including congenital adrenal hyperplasia where control of excessive ACTH secretion is clinically desirable.