STUDIES ON ADRENOCORTICAL EOSINOPENIA: A CLINICAL AND STATISTICAL EVALUATION OF FOUR-HOUR EOSINOPHIL RESPONSE TESTS 12

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Abstract
In order to test the validity of eosinophil response tests to ACTH, epinephrine, ephedrine or placebos, as clinical tools in diagnosis and as indices of activity of the hypothalamus, pituitary or adrenal cortex, 702 tests were made in 204 patients. Observations were made on the intrinsic error of chamber eosinophil counts and on technical errors in testing. Despite careful technic, individual eosinophil response tests are very inaccurate. Failure of response to ACTH is suggestive of Addison''s disease. Repeated intraven. tests should be employed before failure of producing eosinopenia is attributed to adrenocortical insufficiency. Greater than 50% drop of eosinophils has been noted following epinephrine or ephedrine in patients with pituitary tumors and in patients adrenalectomized and receiving small doses of cortisone. Responses of less than 50% are seen in a large number of patients with unrelated pathological conditions. Tests with these two substances are therefore of little value in the diagnosis of adrenal, hypothalamic, or pituitary disease, and do not accurately assess the functional capacity of these organs at the time of examination.
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