METYRAPONE AND PYROGEN TESTS IN HYPERADRENOCORTICISM: EVALUATION OF BLOOD CORTICOTROPHIN LEVELS

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Abstract
SUMMARY Corticotrophin in blood was measured in four normal subjects and four patients suffering from Cushing's syndrome. The basal values of both groups were not statistically different. A standard Piromen test produced a statistically significant increase in normal patients; inconsistent results were obtained in hyperadrenocorticism. A metyrapone test showed significantly increased blood levels of ACTH in the normal subjects and a lower response in the patients with Cushing's syndrome. The Piromen test was also performed after 2 days of metyrapone administration (metyrapone-Piromen test). This test in normal patients induced an ACTH release that may be considered maximal (up to 17 m-u./100 ml.) presumably by relaxing the cortisol 'brake' on the hypothalamus; the response in the patients with hyperadrenocorticism was negative.

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