PLASMA CORTISOL PROFILES IN CUSHING'S SYNDROME

1979 ◽  
Vol 91 (2) ◽  
pp. 319-328 ◽  
Author(s):  
Koichiro Yoshida ◽  
Hiroshi Satowa ◽  
Akio Sato ◽  
Yoichi Ichikawa ◽  
Jacob Kream ◽  
...  
Keyword(s):  
Cushing’S Syndrome ◽  
Bronchogenic Carcinoma ◽  
Plasma Cortisol ◽  
Plasma Concentrations ◽  
Cushing's Syndrome ◽  
Cortisol Concentration ◽  
Adrenocortical Adenoma ◽  
Plasma Acth ◽  
Plasma Cortisol Concentration ◽  
Coefficients Of Variation

ABSTRACT Plasma cortisol profiles were studied by the frequent sampling method in 5 patients with Cushing's disease (CD), 7 patients with Cushing's syndrome due to adrenocortical adenoma (AA), and one patient with bronchogenic carcinoma. Plasma ACTH was measured by radioimmunoassay at 10 min intervals in 2 of the subjects. In CD, there was distinct episodic secretion of cortisol and ACTH; the coefficients of variation about the mean plasma cortisol concentration ranged from 24 to 27 %; plasma ACTH ranged from zero to 455 pg/ml with a mean of 94 pg/ml. In AA, the tumour secreted cortisol at a constant rate with little fluctuation; the coefficients of variation of plasma cortisol concentration ranged from 8 to 14%; plasma concentrations of ACTH were always near zero. In the patient with bronchogenic carcinoma, the coefficient of variation of cortisol was 14 %. These results were apparent even in profiles of plasma cortisol concentrations measured over only a 6 h period. It is concluded that characteristics of plasma cortisol and ACTH secretory patterns are helpful in differentiating Cushing's syndrome of differing aetiology.

Cyclic Cushing's syndrome combined with cortisol suppressible, dexamethasone non-suppressible ACTH secretion: a new variant of Cushing's syndrome

1985 ◽  
Vol 110 (3) ◽  
pp. 289-295 ◽  
Author(s):  
Hans-Udo Schweikert ◽  
Horst Lorenz Fehm ◽  
Rudolf Fahlbusch ◽  
Rainer Martin ◽  
Rainer Kolloch ◽  
...  
Keyword(s):  
Cushing’S Syndrome ◽  
Normal Tissue ◽  
Plasma Cortisol ◽  
Cushing's Syndrome ◽  
Cortisol Secretion ◽  
Plasma Acth ◽  
Acth Secretion ◽  
Normal Response ◽  
New Variant ◽  
Marked Suppression

Abstract. A 55 year old woman with an unusual form of Cushing's disease was studied. During several periods (periods lasting up to 84 days) evidence of cortisol hypersecretion with cycles occurring every 6 days was found. Suppression of plasma cortisol through orally administered dexamethasone (up to 32 mg per day) could not be achieved either during periods of cyclic cortisol hypersecretion or during apparent remission with normal cortisol secretion. Marked suppression of plasma ACTH was measured in response to an iv infusion of 50 mg cortisol over a period of 55 min whereas a similar test with 2 mg dexamethasone (iv bolus) did not suppress ACTH secretion. Transsphenoidal exploration of the sella revealed a tumour surrounding the anterior pituitary. Examination of the pituitary showed a few tiny tumour structures embedded in normal tissue which could not be removed, when the tumour was resected selectively under preservation of normal appearing tissue. Post-operatively, clinical and chemical remission (normal response to 1 mg dexamethasone) was observed for about 4 months. Thereafter, cortisol hypersecretion occurred again necessitating bilateral adrenalectomy. Our results are compatible with the assumption that normal hypothalamic-pituitary-adrenal suppressibility with cortisol, but not with dexamethasone, was caused by the loss of feedback receptors for dexamethasone in the presence of cortisol receptors in the cells which secrete ACTH or CRF. The combination of cyclic hypercortisolism with dexamethasone non-suppressible Cushing's syndrome has not been reported before and thus represents a new variant of Cushing's syndrome.

PLASMA CONCENTRATIONS OF CORTISOL IN HYPOPHYSECTOMIZED AND SODIUM CHLORIDE-ADAPTED GOLDFISH (CARASSIUS AURATUS L.)

1974 ◽  
Vol 63 (2) ◽  
pp. 377-387 ◽  
Author(s):  
JACQUELINE PORTHÉ-NIBELLE ◽  
BRAHIM LAHLOU
Keyword(s):  
Sodium Chloride ◽  
Fresh Water ◽  
Plasma Cortisol ◽  
Carassius Auratus ◽  
Plasma Concentrations ◽  
Cortisol Concentration ◽  
Control Fish ◽  
Chloride Solutions ◽  
Sodium Chloride Solutions ◽  
Plasma Cortisol Concentration

SUMMARY Plasma cortisol concentrations, measured by competitive protein-binding, were examined in intact and hypophysectomized goldfish (Carassius auratus L.) adapted to fresh water or to 210 mm-sodium chloride solutions. The mean plasma cortisol concentration of freshwater-adapted fish (6·6 ± 1·8 (s.e.m.) μg/100 ml plasma) increased after stress and intraperitoneal injections of mammalian corticotrophin. Hypophysectomy resulted in a reduction in plasma cortisol concentration to about 2 μg/100 ml plasma. Transfer of fish to sodium chloride solutions caused rapid, but transitory increases in the plasma cortisol concentrations in intact, but not in hypophysectomized fish. After 3 days in the sodium chloride solution the cortisol levels were similar to those of control fish kept in fresh water. The plasma concentrations of this corticosteroid in goldfish appear to be unrelated to external salinity, although a 'mineralocorticoid' action of the hormone cannot be excluded.

scholarly journals Plasma profiles of adrenocorticotropic hormone, cortisol, α-melanocyte-stimulating hormone, and growth hormone in dogs with pituitary-dependent hyperadrenocorticism before and after hypophysectomy

2006 ◽  
Vol 190 (3) ◽  
pp. 601-609 ◽  
Author(s):  
J M Hanson ◽  
H S Kooistra ◽  
J A Mol ◽  
E Teske ◽  
B P Meij
Keyword(s):  
Plasma Cortisol ◽  
Adrenocorticotropic Hormone ◽  
Plasma Concentrations ◽  
Pulse Frequency ◽  
Cortisol Concentration ◽  
Melanocyte Stimulating Hormone ◽  
Plasma Cortisol Concentration ◽  
Before And After ◽  
Basal Plasma ◽  
Stimulating Hormone

The 6-h plasma profiles of adrenocorticotropic hormone (ACTH), cortisol, α-melanocyte-stimulating hormone (α-MSH), and GH were studied in 17 dogs with pituitary-dependent hyperadrenocorticism (PDH) before and after hypophysectomy. The aim of the study was to investigate the relation between the hormone profile characteristics and recurrence of PDH after surgery. The hormones were secreted in a pulsatile fashion. The basal plasma cortisol concentration and area under the curve (AUC) for cortisol were significantly higher in the PDH cases than in eight controls. The characteristics of the plasma profiles of ACTH and α-MSH were not significantly different between the PDH cases and the controls. In the PDH cases, less GH was secreted in pulses than in the controls, but the difference was not significant. The basal plasma cortisol concentration, the AUC for ACTH and cortisol, and the pulse frequency of ACTH and cortisol decreased significantly after hypophysectomy for the group of PDH cases. The basal plasma concentrations of ACTH and α-MSH, the AUC for α-MSH, and the characteristics of the plasma GH profiles of the PDH cases remained unchanged after hypophysectomy. No pulses of α-MSH were observed after hypophysectomy. The co-occurrence between the ACTH and cortisol pulses decreased significantly with hypophysectomy. The postoperative pulse frequency of ACTH was the only characteristic with predictive value for the recurrence of PDH after hypophysectomy. The results of this study demonstrate that ACTH, cortisol, α-MSH, and GH are secreted in a pulsatile fashion in dogs with PDH. Hypophysectomy effectively reduces the secretion of ACTH and cortisol. The presence of ACTH pulses after hypophysectomy is a risk factor for the recurrence of hyperadrenocorticism.

scholarly journals Clinical Characteristics of Endogenous Cushing’s Syndrome at a Medical Center in Southern Taiwan

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Shih-Chen Tung ◽  
Pei-Wen Wang ◽  
Rue-Tsuan Liu ◽  
Jung-Fu Chen ◽  
Ching-Jung Hsieh ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Cushing’S Syndrome ◽  
Plasma Cortisol ◽  
Medical Center ◽  
Cushing's Syndrome ◽  
Dexamethasone Suppression Test ◽  
Adrenocortical Adenoma ◽  
Suppression Test ◽  
Southern Taiwan ◽  
Dexamethasone Suppression

From January 1987 to December 2011, over a total of 25 years, 84 patients with Cushing’s syndrome (CS) were identified at a medical center in southern Taiwan. We observed a higher incidence of ACTH-independent CS (75%) than ACTH-dependent CS (25%). A higher incidence of adrenocortical adenoma (58.3%) than Cushing’s disease (CD, 21.4%) was also found. The sensitivity of the definitive diagnostic tests for CS, including loss of plasma cortisol circadian rhythm, a baseline 24 h urinary free cortisol (UFC) value >80 μg, and overnight and 2-day low-dose dexamethasone suppression test, was between 94.4% and 100%. For the 2-day high-dose dexamethasone suppression test for the differential diagnosis of CD, the sensitivity of 0800 h plasma cortisol and 24 h UFC was 44.4% and 85.7%, respectively. For the differential diagnosis of adrenal CS, the sensitivities of the 0800 h plasma cortisol and 24 h UFC were 95.5% and 88.9%, respectively. In patients with ACTH-independent CS and ACTH-dependent CS, the baseline plasma ACTH levels were all below 29 pg/mL and above 37 pg/mL, respectively. The postsurgical hospitalization stay following retroperitoneoscopic adrenalectomy was shorter than that observed for transabdominal adrenalectomy (4.3 ± 1.6 versus 8.8 ± 3.7 days,P<0.001). It was easy to develop retroperitoneal and peritoneal seeding of adrenocortical carcinoma via laparoscopic adrenalectomy.

Changes in ovine fetal adrenocortical responsiveness after long-term hypoxemia

1993 ◽  
Vol 264 (5) ◽  
pp. E741-E747 ◽  
Author(s):  
L. M. Harvey ◽  
R. D. Gilbert ◽  
L. D. Longo ◽  
C. A. Ducsay
Keyword(s):  
Arterial Pressure ◽  
High Altitude ◽  
Plasma Cortisol ◽  
Cortisol Concentration ◽  
Plasma Acth ◽  
Fetal Plasma ◽  
Acth Challenge ◽  
Plasma Cortisol Concentration ◽  
Ovine Fetal

This study tested the hypothesis that in the fetus long-term hypoxemia induces premature adrenocortical maturation and augments adrenal responsiveness to adrenocorticotropin hormone (ACTH). Pregnant ewes were exposed to high altitude (3,820 m) from 30 to 120 days gestation, when surgery was performed. Maternal arterial pressure of O2 (PaO2) was maintained at approximately 60 Torr by N2 infusion through a tracheal catheter. Fetal PaO2 was significantly lower in the hypoxemic (21 +/- 0.2 Torr) vs. normoxic (26 +/- 0.4 Torr) fetuses (P < 0.01). Between 125 and 140 days, basal ACTH and cortisol concentrations were similar in both groups. To assess changes in adrenal responsiveness, we challenged the fetuses with ACTH (100 ng/kg body wt, iv bolus) at 126 and 136 days. At 126 days, after ACTH challenge, fetal plasma ACTH peaked at similar values (275 +/- 43 and 250 +/- 26 pg/ml) in normoxic and hypoxemic fetuses, respectively. Plasma cortisol subsequently increased to 84 +/- 8 and 44 +/- 6 ng/ml in these groups. At 136 days, after ACTH challenge, plasma ACTH peaked at 379 +/- 57 and 336 +/- 21 pg/ml in normoxic and hypoxemic fetuses, respectively. Although plasma cortisol concentration in normoxic fetuses increased to 180 +/- 21 ng/ml, levels in hypoxemic fetuses only reached 62 +/- 12 ng/ml (P < 0.05 compared with normoxic). Catecholamine concentrations were not significantly different between the two groups. These data do not support the hypothesis that adrenocortical maturation occurs prematurely, augmenting adrenal responsiveness to ACTH after exposure to long-term hypoxemia. Rather, the ability of the fetus to respond to an ACTH challenge is blunted.

By 94 days of gestation plasma cortisol increases block ACTH response to hypotension in lamb fetuses

1985 ◽  
Vol 249 (4) ◽  
pp. E350-E354
Author(s):  
B. Y. Hargrave ◽  
J. C. Rose
Keyword(s):  
Arterial Pressure ◽  
Plasma Cortisol ◽  
Crossover Design ◽  
Cortisol Concentration ◽  
Plasma Acth ◽  
Fetal Plasma ◽  
Plasma Cortisol Concentration ◽  
Group I ◽  
Group Ii ◽  
Saline Pretreatment

By use of a crossover design, we studied the effects of increasing plasma cortisol concentration on ACTH responses to a standardized stress in 14 lamb fetuses between 94 and 108 days gestation. On a random basis we assigned the animals into two groups of seven. Animals in groups I and II received infusions of cortisol (5 and 1 microgram/min, respectively) or saline for 4 h. After the cortisol or saline pretreatment, we reduced arterial pressure approximately 40-50% in both groups of animals with nitroprusside. After saline pretreatment, hypotension in the group I animals produced an increase in the fetal plasma ACTH from 15 +/- 3 to 200 +/- 20 pg/ml (P less than 0.001), and in the group II animals pretreated with saline plasma ACTH increased from 21 +/- 4 to 141 +/- 19 pg/ml (P less than 0.001) with hypotension. Cortisol pretreatment elevated fetal plasma cortisol levels from 7 +/- 3 to 36 +/- 5 ng/ml in group I and from 8 +/- 4 to 20 +/- 2 ng/ml in group II. The ACTH response to hypotension in both groups was abolished by the cortisol pretreatment. We conclude that by 94 days gestation increases in plasma cortisol within a physiological range block ACTH responses to hypotension in lamb fetuses.

Effect of lairage during 24 h of transport on the behavioural and physiological responses of sheep

1997 ◽  
Vol 65 (3) ◽  
pp. 391-402 ◽  
Author(s):  
M. S. Cockram ◽  
J. E. Kent ◽  
R. E. Jackson ◽  
P. J. Goddard ◽  
O. M. Doherty ◽  
...  
Keyword(s):  
Plasma Cortisol ◽  
Physiological Responses ◽  
Traumatic Events ◽  
Plasma Concentrations ◽  
Road Transport ◽  
Cortisol Concentration ◽  
Continuous Treatment ◽  
Apparent Difference ◽  
Potentially Traumatic Events ◽  
Plasma Cortisol Concentration

AbstractThe effects on the behavioural and physiological responses of sheep of providing rest, food and water (lairage) during 24 h of either road transport or stationary confinement (treatment) were investigated. Twenty-four hours of continuous treatment was compared with 12 h of treatment followed by either 12 h of lairage, 3 h of lairage or 3 h of food and water on the vehicle, followed by a second 12 h of treatment. A further group of sheep was kept as controls. The plasma cortisol concentration was increased at the start of the journey and after 24 h of continuous transport it was still greater than that in controls (P < 0·05). Apart from a mobilization of body energy reserves as indicated by raised plasma concentrations offree fatty acids after 12 h and β-hydroxybutyrate after 24 h there was no evidence that the welfare of the sheep during the journey was compromised after a particular time. During the lairage and immediately after the second 12-h transport period, the sheep appeared to be hungry. Although sheep transported for 24 h without lairage drank more post transport than controls, there was no biochemical evidence of dehydration during the journey. The sheep lay down during the journey and there was no apparent difference between lairage treatments in the proportion of scans spent lying down during either the second 12-h treatment period or during the first 12 h post treatment. There were fewer potentially traumatic events during the second 22 h of the 24-h journey than during the first 12 h of the journey and no apparent effect of lairage during the journey on the frequency of potentially traumatic events during the second 12-h period of transport.There was evidence to suggest that a period of lairage during a 24-h journey can be beneficial in providing sheep with an opportunity to eat, drink and avoid the stressors associated with transport. However, providing hay and water on the vehicle during a 3-h stationary period as compared with unloading into a lairage cannot be recommended. Although sheep readily ate hay on the vehicle, they did not drink sufficient water. This resulted in dehydration and a greater plasma cortisol concentration during the remainder of the journey than in those that had been lairaged for 12 h and a greater water intake post transport than in those given either no lairage or 12 h of lairage.

RADIOIMMUNOASSAY OF PLASMA ADRENOCORTICOTROPHIN IN CUSHING'S SYNDROME

1973 ◽  
Vol 59 (3) ◽  
pp. 439-449 ◽  
Author(s):  
R. J. M. CROUGHS ◽  
C. F. TOPS ◽  
F. H. de JONG
Keyword(s):  
Cushing’S Syndrome ◽  
Plasma Cortisol ◽  
Pituitary Tumour ◽  
Cushing's Syndrome ◽  
Cortisol Response ◽  
Plasma Acth ◽  
Basal Plasma ◽  
Acth Release

SUMMARY The present study describes a radioimmunoassay for plasma adrenocorticotrophin (ACTH) in man with a sensitivity of at least 15 pg/ml. In-vitro studies using various fragments of ACTH showed immunobiological dissociation. However, this phenomenon does not appear to be of major importance in vivo, since stimulation and suppression tests showed overall parallel changes of immunoreactive plasma ACTH and plasma cortisol. The results obtained from patients with various forms of Cushing's syndrome are presented. It is concluded that basal plasma ACTH determinations are useful in the differential diagnosis of Cushing's syndrome and may help in predicting the development of a pituitary tumour after adrenalectomy. The supranormal plasma cortisol response to i.m. injection of lysinevasopressin in subjects with pituitary-dependent Cushing's syndrome is attributed both to an increased ACTH release by the pituitary and to an excessive response of the hyperplastic adrenal cortex. The i.v. infusion of dexamethasone at a rate of 1 mg/h for 5 h in subjects with pituitarydependent Cushing's syndrome was followed by significant and parallel decreases of both immunoreactive plasma ACTH and plasma cortisol. No rise of plasma ACTH levels was found with insulin-induced hypoglycaemia in subjects with untreated pituitary-dependent Cushing's syndrome.

DIURNAL VARIATION IN PLASMA CORTISOL AND PROLACTIN IN PATIENTS WITH CUSHING'S SYNDROME

1978 ◽  
Vol 88 (4) ◽  
pp. 737-743 ◽  
Author(s):  
Claus Hagen ◽  
Henrik Kehlet ◽  
Christian Binder
Keyword(s):  
Cushing’S Syndrome ◽  
Diurnal Rhythm ◽  
Plasma Cortisol ◽  
Normal Subjects ◽  
Cushing's Syndrome ◽  
Ectopic Acth Syndrome ◽  
Adrenocortical Adenoma ◽  
Plasma Prolactin ◽  
Ectopic Acth ◽  
Oat Cell Carcinoma

ABSTRACT To evaluate the relationship between plasma prolactin and cortisol in patients with Cushing's syndrome, the 24 h pattern of these hormones was measured in normal subjects and in 5 patients with pituitary dependent Cushing's syndrome and 2 patients with Cushing's syndrome due to an adrenocortical adenoma and ectopic secretion of ACTH. The normal subjects showed an increase in plasma prolactin during late sleep without correlation (P > 0.05) to changes in plasma cortisol. All patients had normal basal levels (between 10 a. m. and 12 p. m.) of plasma prolactin. Four of 5 patients with pituitary dependent Cushing's syndrome had an absent diurnal rhythm of plasma prolactin. One patient classified as pituitary dependent Cushing's syndrome on the basis of adrenal pathology, but pituitary independent on the basis of the dexamethasone suppression test had a normal circadian rhythm of plasma prolactin suggesting that the disease is not pituitary dependent at this stage. Two patients with pituitary independent Cushing's syndrome, one with adrenocortical adenoma and one with an oat cell carcinoma of the lung and the ectopic ACTH syndrome and very elevated plasma cortisol levels showed a normal and an absent diurnal rhythm of prolactin, respectively.

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