PLASMA ADRENOCORTICOTROPIN AND CORTISOL RESPONSES TO OVINE CORTICOTROPIN-RELEASING FACTOR IN PATIENTS WITH ADRENOCORTICAL INSUFFICIENCY DUE TO HYPOTHALAMIC AND PITUITARY DISORDERS

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Abstract
Plasma ACTH and cortisol responses to intravenous injection of 100 µg synthetic ovine corticotropinreleasing factor (CRF) were studied in 4 patients with hypothalamic hypopituitarism, 2 patients with Sheehan′s syndrome, 2 patients with isolated ACTH deficiency and 10normal subjects. All 4 patientswith hypothalamic hypopituitarism had exaggerated plasma ACTH responses to CRF compared to normal subjects and gradual but definite increases in plasma cortisol from low basal levels. Of 2 patients with Sheehan's syndrome, one had slight ACTH and cortisolincreases after CRF injection, whereas the other had no increase in either. In 2 patients with isolated ACTH deficiency, plasma ACTH and cortisol remained undetectable (ACTH <10 pg/ml, cortisol <0.6 µg/dl) after CRF injection. These results suggest that the CRF test is auseful tool in evaluating patients with secondary adrenocortical deficiency.

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