ACTH AND CORTISOL RESPONSES TO OVINE CORTICOTROPHIN-RELEASING FACTOR IN PATIENTS WITH PRIMARY AND SECONDARY ADRENAL FAILURE

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Abstract
The ACTH and cortisol responses to an i.v. injection of 100 .mu.g ovine CRF [corticotropin-releasing factor] were studied in 19 patients with adrenal failure. In all 8 patients with primary adrenal failure, plasma ACTH levels increased from a mean basal level of 1494 .+-. 431 (standard error of the mean) pg/ml to a peak value of 2601 .+-. 1220 pg/ml at 10 min. In comparison with healthy subjects absolute ACTH increments after ovine CRF were significantly augmented in the patients with Addison''s disease (P* < 0.001), and the absolute ACTH responses after ovine CRF were positively correlated with the basal plasma ACTH levels. The 11 patients with secondary adrenal insufficiency could be subdivided into 2 groups: those having little or no ACTH and cortisol response to ovine CRF (5 patients) and those having prolonged and pronounced ACTH responses with a biphasic pattern and a delayed 2 peak (6 patients), followed in all patients by a marked cortisol increase. Apparently, the CRF-test can discriminate between hypothalamic and pituitary causes of secondary adrenal failure.

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