IN VIVO AND IN VITRO STUDIES OF ADRENAL SECRETIONS IN CUSHING'S SYNDROME AND PRIMARY ALDOSTERONISM*

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Abstract
Corticoid secretion rates were determined by the double isotope technique. Cortisol secretion was consistently elevated in Cushing''s syndrome. Corticosterone secretion was normal except in a single case of malignancy. Aldosterone secretion was normal to low, as was urinary aldosterone. Analysis of hyperplastic glands showed normal concentrations of cortisol, 11-desoxycortisol, aldosterone, corticosterone and desoxycorticosterone. Analysis of adenoma content revealed normal cortisol, lowered corticosterone and low to absent aldosterone. The suppressed ipsilateral adrenal had low cortisol and corticosterone but normal amounts of aldosterone, desoxycorticosterone and 11-desoxycortisol. Adrenal tissue suppressed by exogenous or endogenous cortisol was capable of secreting normal amounts of aldosterone. In primary aldosteronism aldosterone secretion was greatly increased, whereas cortisol secretion was normal. In 3 of 7 cases corticosterone secretion was increased. Tumor cortisol was normal but corticosterone, desoxycorticosterone and aldosterone were increased. Aldosterone secretion appears independent of cortisol excess.