COMPLICATIONS IN THE MANAGEMENT OF CUSHING'S SYNDROME, INCLUDING ANAPHYLACTIC REACTION TO INTRAVENOUS ADRENOCORTICOTROPIN AFTER SUBTOTAL ADRENALECTOMY*

Abstract
A detailed case report is presented of a 40-year-old housewife who underwent subtotal adrenalectomy for Cushing''s syndrome. The difficulties arising in the postoperative period included recurrent crises of adrenal insufficiency, infections, mental depression and an episode suggesting mild rheumatoid arthritis. An unusual feature was the occurrence of an acute anaphylactic reaction to ACTH in the eight postoperative month. The patient''s serum was observed to contain reagin-like antibodies to several ACTH preparations, including samples derived from sheep, pig, horse and whale pituitaries. A brief discussion of the significance of the findings in this patient is presented.

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