HYPOKALIEMIC, HYPOCHLOREMIC ALKALOSIS IN CUSHING'S SYNDROME. OBSERVATIONS ON THE EFFECTS OF TREATMENT WITH POTASSIUM CHLORIDE AND TESTOSTERONE*

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Abstract
ALKALOSIS associated with hypokaliemia and hypochloremia in certain L cases of Cushing's syndrome has been reported by McQuarrie et al. (1), and Anderson et al. (2) and studied in detail by Kepler and his associates (3, 4, 5, 6, 7). Although the precise mechanism responsible for this disturbance in electrolyte balance has not yet been elucidated, a basis for an understanding of it has come from the studies of Darrow (8, 9). This investigator has shown that, in rats at least, there is a high degree of correlation between the sodium and potassium content of muscle and the serum chloride and bicarbonate after biologic equilibrium has been established. Deficit of potassium induced by a low potassium diet and/or injections of desoxycorticosterone resulted in an increase in serum bicarbonate and muscle sodium and a decrease in muscle potassium and serum chloride. Similar changes were found during alkalosis from chloride deficit. Rats suffering from acidosis due to sodium deficit exhibited a decreased intracellular sodium with normal or slightly elevated muscle potassium when serum bicarbonate was decreased.