The use of the corticotropin-releasing hormone test to monitor the recovery of patients with Cushing's disease or Cushing's syndrome due to an adrenal adenoma after adenomectomy.

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Abstract
Six patients with Cushing''s disease and 3 with Cushing''s syndrome due to an adrenal adenoma were monitored after their adenomectomy with the corticotropin-releasing hormone test to evaluate the progress of recovery of their pituitary adrenal function. Before surgery the patients with Cushing''s disease showed either high, normal or low responses of plasma ACTH and cortisol to 100 .mu.g synthetic ovine corticotropin-releasing hormone (CRH) administered i.v.; all 3 patients with Cushing''s syndrome due to an adrenal adenoma showed no response of plasma ACTH or cortisol to CRH. One or 2 mo. after surgery, the patients who had Cushing''s disease had low levels of basal plasma ACTH and cortisol and their responses to CRH were extremely low. The same patients were tested later; their responses to CRH gradually increased and reached normal ranges approximately within 1 yr after tumor removal, which coincided with the overall improvement in their clinical signs and symptoms due to adrenal insufficiency. The recovery of the pituitary adrenal function in patients who had Cushing''s syndrome due to an adrenal adenoma was not complete even 1 yr after surgery. The corticotropin-releasing factor test is a useful criteria to evaluate the recovery of the pituitary adrenal function in these patients after surgery, since the responses of plasma ACTH and cortisol to the administered CRH are parallel with the improvements in clinical signs and symptoms due to adrenal insufficiency in patients with Cushing''s disease.

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