SHORT-TERM FLUCTUATIONS IN PLASMA CORTISOL IN CUSHING'S SYNDROME

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Abstract
Short-term fluctuations in plasma cortisol were determined overnight in 12 patients with Cushing''s syndrome: 8 patients with bilateral adrenal hyperplasia of hypothalamic-pituitary origin, 3 patients with a cortisol producing adenoma and 1 patient with a carcinoma of the adrenal cortex. While either secretory episodes in plasma cortisol or a fixed pattern of cortisol secretion were observed both in patients with pituitary dependent and in those with pituitary independent hypercorticism, a typical night-day variation in plasma cortisol was only found in 1 of the 8 patients with Cushing''s syndrome of hypothalamic-pituitary origin. The patient with a cortisol producing carcinoma showed only minor fluctuations in plasma cortisol throughout the test period. No discrimination can apparently be made between patients with pituitary dependent or independent Cushing''s syndrome by demonstrating an episodic or a fixed secretion of cortisol. The finding of a typical night-day variation in hormone secretion points to hypercorticism of hypothalamic-pituitary origin.

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