URINARY 17-KETOSTEROID AND 17-KETOGENIC STEROID EXCRETION IN CUSHING'S SYNDROME

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Abstract
Utilizing Norymberski's method for determination of urinary 17-ketogcnic steroid (glucocorticoicl) excretion, normal subjects and patients with either suspected or proved Cushing's Syndrome were studied with reference to their response to ACTH stimulation as an indication of adrenocortical function. Of 123 patients studied, 67 were found to have signs and symptoms suggestive of excessive adrenocortical activity. Sixteen of the 67 had definite signs and symptoms of Cushing's syndrome. Of the remaining 51 patients, 36 (70 per cent) showed abnormal responses to ACTH stimulation. The 16 patients with frank Cushing's syndrome were treated by bilateral adrenalectomy. It is postulated that Cushing's syndrome may initially be cyclic, or even self limited. A plea is made for continued and repeated observations of patients with signs and symptoms of early disease in order to ascertain the natural history, early treatment, and disability limitations of persistently abnormal adrenocortical function.