Response of ACTH and Cortisol to Corticotropin-Releasing Hormone in Anorexia Nervosa

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To the Editor: As pointed out by Herzog and Copeland in their recent paper (August 1 issue),1 hypothalamic–pituitary–adrenal function is, for unknown reasons, often disordered in patients with anorexia nervosa. This is evidenced by high plasma cortisol levels that lack circadian rhythmicity and are not suppressible by dexamethasone.To define better the functional arrangement of the hypothalamic–pituitary–adrenal axis in this disease, we studied the response of ACTH and cortisol to ovine corticotropin-releasing hormone in 11 patients with anorexia and 6 normal controls matched for weight and age. There were 10 female patients and 1 male patient, 13 to 38 years . . .