QUANTITATIVE EFFECT OF CORTISONE UPON KETOSTEROID EXCRETION AND CLINICAL PICTURE OF THE ADRENOGENITAL SYNDROME*

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Abstract
Cortisone initially administered intramuscularly in doses of 100 mg./ day depressed, within 1 week, the elevated ketosteroid excretion noted in a 37-year-female patient with a 22-year history of adrenogenital syndrome. After 12 days of intramusc. cortisone, the patient was maintained for more than 8 months on oral cortisone. The oral dose was ascertained quantitatively by 17-ketosteroid excretion studies. Excretions below 13 mg./day were maintained by a total daily dose of 37.5 mg. of cortisone in divided doses 3 times daily. During this regimen the patient showed minimal somatic changes, but experienced 9 spontaneous, fairly regular menstrual periods. The comparatively small dose of cortisone (37.5 mg./day), although it adequately depressed the patient''s ketosteroid excretion, adversely affected her mild diabetic state and made its control with insulin difficult. Before cortisone therapy, massive doses of estrogen, progesterone, and p-hydroxypropiophenone had failed to produce significant changes with respect to her amenorrhea or ketosteroid excretion.

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