THE URINARY EXCRETION OF 3α,17α,21-TRIHYDROXY-5β-PREGNAN-20-ONE (TETRAHYDRO S) FOLLOWING ADMINISTRATION OF CORTICOTROPHIN AND METOPIRONE (CIBA SU 4885)

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Abstract
The results of simultaneous measurements of urinary 17-ketogenic steroids and 3[alpha], 17[alpha], 21-trihydroxy-5[beta]-pregnan-20-one (tetrahydro S) are reported from patients without any endocrine disorders following administration for 3 days of adreno-corticotrophic hormone (ACTH) (15 patients) and oral administration of Metopirone (9 patients). The data obtained are compared with similar determinations performed in 2 patients with Cushing''s syndrome, 4 patients with hirsutism, 6 patients with suspected pituitary failure and 2 patients with absence of pituitary function. In the patients with no endocrine disorder, tetrahydro S increases fourfold on ACTH stimulation, and almost 60 times following Metopirone administration. The very magnitude of the relative increase in tetrahydro S excretion in normal subjects given Metopirone allows a better gradation of subnormal responses of pituitary ACTH than can be obtained when the effect of the test is judged by the excretion of 17-ketogenic steroids alone. Examples illustrating this are presented in the paper.