17-ketosteroids and Cushing-Syndrome

Topics: 17-Ketosteroids; Adrenal Hyperplasia, Congenital; Biomarkers; Colorimetry; Cushing Syndrome; Diagnosis, Differential; Female; Humans; Male; Reference Values; Specimen Handling

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; ACTH Syndrome, Ectopic; Addison Disease; Adrenal Gland Diseases; Biomarkers; Colorimetry; Cushing Syndrome; Humans; Reference Values; Thyroid Diseases

A 53-year-old female had clinical and laboratory findings suggestive of Cushing's syndrome. In contrast to the Cushing's syndrome caused by cortical adenoma, a high level of urinary 17-ketosteroids (17-KS) was also noted. Imaging studies revealed a right adrenal tumor. Right adrenectomy was performed; the surgical specimen revealed a black adenoma consisting of compact cells with numerous pigments which seemed to be lipofuscin in nature. The present case indicates that black adenoma as well as adrenocortical carcinoma should be suspected, when patients with Cushing's syndrome show an increased level of urinary 17-KS excretion.

Topics: 17-Ketosteroids; Adrenal Cortex Neoplasms; Adrenocortical Adenoma; Cushing Syndrome; Female; Humans; Middle Aged

Topics: 17-Ketosteroids; Adenoma; Adrenal Cortex Neoplasms; Adrenocorticotropic Hormone; Adult; Androgens; Carcinoma; Child, Preschool; Cushing Syndrome; Estrogens; Female; Feminization; Glucocorticoids; Granulosa Cell Tumor; Humans; Leydig Cell Tumor; Male; Mesenchymoma; Middle Aged; Mitotane; Ovarian Neoplasms; Paraneoplastic Endocrine Syndromes; Pregnancy; Progesterone; Prognosis; Sertoli Cell Tumor; Steroids; Testicular Neoplasms; Thecoma; Virilism

Eight cases of adrenocortical tumor are presented with a review of the literature. Although such tumors are rare, they are important causes of inappropriate virilization and Cushing's syndrome in childhood. Clinical virilization with or without hypercortisolism was found in all eight children, who were 5 years old or younger. Excessive linear growth was noted, despite evidence of hypercortisolism. Serum levels of dehydroepiandrosterone, dehydroepiandrosterone sulfate, testosterone, and cortisol were elevated in all cases tested and appear to be useful diagnostic alternatives to the more traditional determinations of urine 17-ketosteroids and 17-hydroxycorticosteroids. Abdominal sonography and computed tomography have proven to be reliable tools for tumor localization. Surgical resection was the definitive therapy in all patients, and perioperative steroid replacement was essential. Histologic diagnosis appeared to have little bearing on prognosis, and the majority of pediatric patients have had clinically benign disease. At a mean follow-up of 3 years, seven of the eight children were alive and had no evidence of tumor recurrence.

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adenocarcinoma; Adenoma; Adrenal Cortex Neoplasms; Child, Preschool; Cushing Syndrome; Dehydroepiandrosterone; Female; Follow-Up Studies; Humans; Hydrocortisone; Infant; Male; Puberty, Precocious; Testosterone; Virilism

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Addison Disease; Adolescent; Adrenocorticotropic Hormone; Adult; Age Factors; Aged; Circadian Rhythm; Cushing Syndrome; Female; Humans; Liver Diseases; Male; Metyrapone; Middle Aged; Pregnancy; Thyroid Diseases

Topics: 17-Ketosteroids; Adolescent; Adrenal Cortex; Adrenocortical Hyperfunction; Androgen-Insensitivity Syndrome; Child; Cushing Syndrome; Endocrine Glands; Estrogens; Female; Follicle Stimulating Hormone; Humans; Hydrocortisone; Hypothalamo-Hypophyseal System; Luteinizing Hormone; Male; Menstruation; Ovary; Pituitary Gland, Anterior; Pituitary Hormones; Puberty; Puberty, Precocious; Reproduction; Turner Syndrome

Topics: 17-Ketosteroids; Adrenal Glands; Androgens; Chemistry Techniques, Analytical; Chromatography, Thin Layer; Cushing Syndrome; Female; Gonadotropins; Hirsutism; Humans; Male; Polycystic Ovary Syndrome; Sex Factors; Testosterone; Thyroid Diseases; Virilism

Topics: 17-Ketosteroids; Addison Disease; Adolescent; Adrenal Glands; Adrenal Insufficiency; Adult; Aldosterone; Androgens; Child; Cushing Syndrome; Dehydroepiandrosterone; Desoxycorticosterone; Dexamethasone; Female; Humans; Hydrocortisone; Hyperaldosteronism; Hypertension; Infant; Male; Pituitary-Adrenal Function Tests; Renin; Spironolactone; Virilism

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Addison Disease; Adolescent; Adrenal Gland Diseases; Adrenocorticotropic Hormone; Adult; Age Factors; Aged; Blood Chemical Analysis; Child; Circadian Rhythm; Cushing Syndrome; Female; Humans; Liver Diseases; Male; Middle Aged; Pituitary-Adrenal Function Tests; Pregnancy; Stress, Physiological; Surgical Procedures, Operative; Thyroid Diseases

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adolescent; Adrenalectomy; Age Factors; Child; Cushing Syndrome; Female; Humans; Infant; Male

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Addison Disease; Adrenal Cortex Hormones; Adult; Age Factors; Circadian Rhythm; Cushing Syndrome; Female; Humans; Hyperthyroidism; Hypopituitarism; Hypothyroidism; Infant, Newborn; Liver Cirrhosis; Middle Aged; Pituitary Function Tests; Pituitary-Adrenal Function Tests; Pregnancy; Stress, Physiological

Topics: 17-Ketosteroids; Adolescent; Adrenal Gland Neoplasms; Adrenocorticotropic Hormone; Adult; Cushing Syndrome; Female; Humans; Hyperplasia; Male; Middle Aged; Pituitary Neoplasms; Precancerous Conditions

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adolescent; Adrenal Cortex Hormones; Adrenocorticotropic Hormone; Adult; Body Constitution; Cushing Syndrome; Dehydroepiandrosterone; Dexamethasone; Ecchymosis; Female; Hemorrhagic Disorders; Humans; Hydrocortisone; Male; Osteoporosis; Periodicity; Pneumoperitoneum, Artificial; Proteins; Radiography

Topics: 17-Ketosteroids; Adaptation, Psychological; Addison Disease; Adrenal Gland Diseases; Adrenal Gland Neoplasms; Cortisone; Cushing Syndrome; Dexamethasone; Female; Genitalia, Female; Glucocorticoids; Growth; Humans; Hydrocortisone; Hyperplasia; Male; Pituitary Diseases; Pituitary Gland; Prognosis; Sodium Chloride; Sodium Salicylate

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenocortical Hyperfunction; Chemistry, Clinical; Corticosterone; Cushing Syndrome; Diagnosis, Differential; Female; Glucocorticoids; Humans; Hydrocortisone; Hypogonadism; Kidney Failure, Chronic; Male; Methods; Obesity; Pregnancy; Pregnancy Complications

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Addison Disease; Adolescent; Adult; Age Factors; Circadian Rhythm; Cushing Syndrome; Female; Humans; Liver Diseases; Male; Pituitary-Adrenal Function Tests; Pregnancy; Thyroid Diseases

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adolescent; Adrenal Cortex Hormones; Adrenal Glands; Adult; Androgens; Cushing Syndrome; Female; Humans; Middle Aged; Obesity; Pituitary-Adrenal Function Tests; Pregnanetriol

Topics: 17-Ketosteroids; Addison Disease; Adrenal Insufficiency; Adrenocorticotropic Hormone; Biochemical Phenomena; Biochemistry; Blood Chemical Analysis; Clinical Laboratory Techniques; Cushing Syndrome; Hypoadrenocorticism, Familial; Hypopituitarism; Metyrapone; Pathology; Physiology; Pituitary-Adrenal Function Tests; Urine

Topics: 17-Ketosteroids; Adrenal Cortex Hormones; Adrenal Gland Neoplasms; Androsterone; Blood; Chorionic Gonadotropin; Cushing Syndrome; Dysgerminoma; Estradiol; Estrone; Female; Follicle Stimulating Hormone; Gonadotropins; Humans; Hypertrichosis; Hypogonadism; Metabolism; Ovarian Neoplasms; Ovary; Polycystic Ovary Syndrome; Pregnenolone; Progesterone; Testosterone; Urine; Virilism

Topics: 17-Ketosteroids; Adrenocortical Hyperfunction; Aminoglutethimide; Androsterone; Aniline Compounds; Anticonvulsants; Chemistry, Clinical; Clinical Trials as Topic; Cushing Syndrome; Dehydroepiandrosterone; Etiocholanolone; Glucocorticoids; Humans; Hyperplasia; Hypogonadism; Pyridones; Testosterone

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adenoma; Adolescent; Adrenal Gland Diseases; Adrenal Gland Neoplasms; Adrenocorticotropic Hormone; Adult; Aged; Blood Chemical Analysis; Carcinoma; Clinical Trials as Topic; Cushing Syndrome; Female; Humans; Hyperplasia; Male; Metyrapone; Middle Aged; Pregnanes

Topics: 17-Ketosteroids; Acetates; Adenoma; Androgen-Insensitivity Syndrome; Androgens; Androsterone; Carbon Isotopes; Chemistry, Clinical; Chromatography, Paper; Clinical Trials as Topic; Cushing Syndrome; Etiocholanolone; Female; Hirsutism; Humans; Hyperaldosteronism; Male; Methods; Myoma; Puberty, Precocious; Testosterone; Tritium; Uterine Neoplasms

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenal Cortex Hormones; Adrenal Gland Neoplasms; Adrenal Glands; Adrenal Insufficiency; Carcinoma; Clinical Trials as Topic; Cushing Syndrome; Depression, Chemical; Female; Humans; Middle Aged; Natriuresis; Phenethylamines; Pregnanes; Water-Electrolyte Balance

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenocorticotropic Hormone; Adult; Aldosterone; Body Weight; Clinical Trials as Topic; Cushing Syndrome; Female; Humans; Hyperaldosteronism; Hypopituitarism; Male; Metyrapone; Middle Aged; Natriuresis; Pituitary-Adrenal System; Potassium; Secretory Rate

Topics: 17-Ketosteroids; Adenocarcinoma; Adolescent; Adrenal Gland Diseases; Adrenal Gland Neoplasms; Adrenocortical Hyperfunction; Adult; Clinical Trials as Topic; Creatine; Cushing Syndrome; Dexamethasone; Female; Humans; Hydrocortisone; Male; Middle Aged; Pituitary Function Tests

Topics: 17-Ketosteroids; Adolescent; Adrenal Hyperplasia, Congenital; Adult; Child; Child, Preschool; Cushing Syndrome; Female; Humans; Infant; Male

We previously reported that the daily urinary unidentified ketosteroid glucuronide (US-G) level in patients with Cushing's syndrome was much higher than that in the healthy subjects. Furthermore, urine samples from patients with Cushing's syndrome, including those with pituitary adenoma and adrenal adenoma, yielded almost the same high excretion levels, despite the different sites of the adenomas. We extracted US obtained by hydrolysis of US-G in urine of patients with Cushing's syndrome, purified it, and analyzed its chemical structure. Molecular weight and molecular formula were analyzed by MS spectrometry, and the chemical structure was analyzed by NMR spectrometry, utilizing small quantities of refined US. The substance has a molecular weight of 304 Da, a molecular formula of C19H28O3, and its chemical structure is 3alpha,11beta-dihydroxyandrost-4-en-17-one.

Topics: 17-Ketosteroids; Chromatography, High Pressure Liquid; Cushing Syndrome; Glucuronides; Humans; Hydrolysis; Magnetic Resonance Spectroscopy; Molecular Weight

Transsphenoidal adenomectomy is currently the first choice for treatment of patients with pituitary ACTH-dependent Cushing's syndrome. However, pharmacotherapy is prescribed for some patients, e.g., unsuccessful surgery. We treated a woman in whom pituitary Cushing's syndrome was improved while she was on antimuscarinic cholinergic agents, atropine sulphate and pirenzepine hydrochloride. The diminished effect of anticholinergics on ACTH and cortisol was incidentally identified in an inferior petrosal sinus sampling procedure. A single intramuscular injection of atropine significantly decreased both ACTH (43.9 pg/ml to less than 12.0; normal, 12.0-40.0 pg/ml) and cortisol (29.9 microg/dl to 13.6; normal, 7.6-23.6 microg/dl). An M1-muscarinic receptor specific antagonist, pirenzepine hydrochloride, also had a diminishing effect on these hormones and this inhibiting effect was partially blocked by the simultaneous administration of an anticholinesterase agent, pyridostigmine bromide. Chronic oral ingestion of these agents led to improvement in clinical symptoms, and urinary 17-hydroxycorticosteroid and 17-ketosteroid levels were at normal to upper-normal levels. This is the first documentation of involvement of the cholinergic system in the pathogenesis of pituitary Cushing's syndrome.

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adenoma; Adrenocorticotropic Hormone; Atropine; Choline; Cushing Syndrome; Dexamethasone; Female; Humans; Hydrocortisone; Metyrapone; Middle Aged; Muscarinic Antagonists; Petrosal Sinus Sampling; Pirenzepine; Pituitary Neoplasms

An adrenocortical adenoma causing Cushing's syndrome (Cushing's adenoma) produces a unilateral concordant visualization (UCV) imaging pattern in which the adenoma is only visualized on radioiodocholesterol adrenocortical scintigraphy. But because this imaging pattern is also noted in some patients with adrenal incidentalomas, we examined whether the UCV-incidentaloma was essentially identical with Cushing's adenoma and would develop Cushing's syndrome. The subjects were 9 patients with UCV-incidentalomas (mean size, 30 mm; range, 20-45 mm) and 6 patients with Cushing's adenomas (mean size, 28 mm; range, 25-35 mm). Endocrinological evaluations showed several abnormalities including blunted diurnal rhythm of plasma cortisol within the normal range, low plasma ACTH and/or high 24-hr urinary 17-OHCS levels in 8 of 9 patients with UCV-incidentalomas, but these abnormalities did not meet the diagnostic criteria of Cushing's syndrome. Adrenal uptake of the tracer in the patients with UCV-incidentalomas was not statistically different from that in the patients with Cushing's adenomas and had no relationship with hormonal values in either patient group. Tumor size on CT correlated with the levels of 24-hr urinary 17-OHCS (r = 0.75, p = 0.02) and plasma cortisol at 7:00 (r = 0.82, p = 0.007) in the patients with UCV-incidentalomas, but not in the patients with Cushing's adenomas. Although 3 UCV-incidentalomas increased slightly in size, none of 9 patients with UCV-incidentalomas has developed Cushing's syndrome for 4 to 52 months. These results suggest that the UCV-incidentaloma may be essentially different from the Cushing's adenoma and unlikely to develop Cushing's syndrome.

Topics: 17-Ketosteroids; Adenoma; Adrenal Cortex; Adrenal Cortex Neoplasms; Adrenocorticotropic Hormone; Adult; Aged; Aldosterone; Cushing Syndrome; Female; Humans; Hydrocortisone; Male; Middle Aged; Radionuclide Imaging; Regression Analysis

We report a case of preclinical Cushing's syndrome in a 54-year-old male associated with bilateral adrenocortical tumours. Physical findings and general laboratory data were unremarkable except for mild hypertension (158/90 mmHg) and impaired glucose tolerance. Endocrinological evaluation revealed the presence of autonomous cortisol secretion including unsuppressible serum cortisol by 8 mg dexamethasone test (11 microg/dl), high serum DHEA-S (3580 ng/ml, normal: 400-3500) and increased urinary 17-KS excretion (31.0-35.8 mg/day, normal: 5.8-21.3). CT scan demonstrated the presence of tumours in both adrenals and bilateral adrenalectomy was subsequently performed. Histological examination of the resected specimens revealed an adrenocortical carcinoma on the right side and an adenoma on the left side with noticeable cortical atrophy in non-neoplastic adrenals. Immunohistochemical study of steroidogenic enzymes demonstrated that all the steroidogenic enzymes involved in cortisol biosynthesis were expressed in both right and left adrenal tumours. Enzymatic activities of 21, 17alpha, 18, 11beta-hydroxylases were detected in both right and left adrenals except for the absence of 11beta-hydroxylase activity in the left adrenal adenoma. Results of in vitro tissue steroidogenesis examined in short-term tissue culture of the specimens revealed no significant differences between carcinoma and adenoma in cortisol production, but the production of adrenal androgens in carcinoma was significantly higher than that in adenoma, which may indicate the importance of evaluating adrenal androgen levels in patients with adrenocortical neoplasms.

Topics: 17-Ketosteroids; Adenoma; Adrenal Cortex Neoplasms; Adrenalectomy; Carcinoma; Culture Techniques; Cushing Syndrome; Dehydroepiandrosterone Sulfate; Dexamethasone; Glucocorticoids; Humans; Hydrocortisone; Immunohistochemistry; Male; Middle Aged; Neoplasms, Multiple Primary; Steroid Hydroxylases; Tomography, X-Ray Computed

Topics: 17-Ketosteroids; Adolescent; Adrenal Cortex Neoplasms; Age Factors; Child; Child, Preschool; Cushing Syndrome; Dehydroepiandrosterone; Environmental Pollutants; Female; Humans; Hypertension; Infant; Infant, Newborn; Male; Prognosis; Retrospective Studies; Sex Factors; Treatment Outcome; Virilism

A 28-year old female patient with virilization due to left adrenocortical adenoma was studied. The patient had clinical features of hyperandrogenism such as hirsutism and a low pitched voice, but not of hypercorticoidism. Plasma testosterone and dehydroepiandrosterone-sulfate (DHEA-S) were high. Although the basal plasma cortisol concentration and urinary excretion of 17-hydroxycorticosteroids (17-OHCS) were within the normal range, the absence of diurnal variation in plasma cortisol and loss of suppressibility by dexamethasone suggested constitutive secretion of cortisol by the tumor. Inappropriate cortisol secretion was also supported by blunted ACTH response to provocative stimuli. After successful removal of the left adrenal tumor, such endocrinological abnormalities were all normalized. Immunohistochemical analysis revealed that tumor cells were positively stained for C21 hydroxylase cytochrome P-450 (P-450C21) and P-450(11) beta which convert 17-hydroxy (OH) progesterone to cortisol as well as P-450SCC, 3 beta-hydroxysteroid dehydrogenase and P-450(17) alpha which are involved in testosterone biosynthesis. These findings suggest that adrenocortical adenoma secretes predominantly testosterone and constitutively cortisol in a young woman patient with virilization.

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adenoma; Adrenal Cortex Neoplasms; Adult; Circadian Rhythm; Cortodoxone; Cushing Syndrome; Dehydroepiandrosterone; Dehydroepiandrosterone Sulfate; Dexamethasone; Female; Humans; Hydrocortisone; Immunohistochemistry; Japan; Testosterone

We present two patients with Cushing's syndrome due to ACTH-independent macronodular adrenal hyperplasia who showed marked plasma cortisol response to lysine-8-vasopressin (LVP) injection (from 930 and 731 pmol/L to 2177 and 1920 pmol/L, respectively), while plasma ACTH levels remained undetectable. The ACTH independence of cortisol secretion in the two patients was determined from the following endocrinological findings. Plasma cortisol levels were not increased by corticotropin-releasing hormone injections and were not suppressed by high dose (16 mg) dexamethasone administrations. The plasma ACTH levels, measured by two independent sensitive immunoassays, were persistently undetectable even after corticotropin-releasing hormone injection, metyrapone administration, and bilateral adrenalectomy. The particular pathological finding of the two cases, atrophic lesions in nonnodular parts of the adrenal cortexes, also indicated ACTH independence of the macronodular hyperplasia. In vitro examination revealed a direct effect of LVP on cortisol secretion from the adrenal cells of the macronodules. We also examined seven patients with Cushing's syndrome caused by adrenal adenoma and found a statistically significant plasma cortisol response to LVP injection. The direct effect of LVP was also demonstrated in cultured adenoma cells. In conclusion, we discovered a direct adrenal effect of LVP on cortisol secretion in patients with ACTH-independent macronodular hyperplasia and, to a lesser extent, in patients with cortisol-producing adrenal adenoma. The cortisol response to LVP may serve to facilitate their diagnosis and choice of therapy.

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adenoma; Adrenal Gland Neoplasms; Adrenocortical Hyperfunction; Adrenocorticotropic Hormone; Adult; Analysis of Variance; Corticotropin-Releasing Hormone; Cushing Syndrome; Dexamethasone; Female; Humans; Hydrocortisone; Immunoradiometric Assay; Lypressin; Male; Middle Aged; Sensitivity and Specificity

We developed a new method for measuring an unidentified ketosteroid glucuronide (US-G) detected by the method of Iwata et al. for measuring 17-ketosteroid glucuronides by reversed phase HPLC on a Capcell-Pak C8 column with three kinds of mobile phase solutions (Iwata method; Clin Chem 35: 795-799, 1989). The Iwata method inadequately separated US-G and two hydroxy 17-ketosteroides, 11 beta-hydroxyetiocholanolone and 11 beta-hydroxyandrosterone, and it exhibits insufficient sensitivity for measuring traces of US-G in the urine of healthy subjects. We solved these problems by developing a new method which measures US-G in urine, as a free type by hydrolyzing the glucuronide type enzymatically, by normal phase HPLC on a Capcell-Pak Silica column with one kind of mobile phase solution. By this method, the levels of US excreted as a glucuronide in the urine of healthy subjects and of patients with Cushing's syndrome were determined as proportions of the levels of 11 beta-hydroxyandrosterone. The average daily urinary excretion of US was 971 micrograms (125-4,995 micrograms) in patients with Cushing's syndrome (n = 22: two males and 20 females aged 26 to 65 years), and 34 micrograms (0-141 micrograms) in healthy subjects (n = 63: 49 males, and 14 females aged 21 to 54 years), and the differences were clearly significant. However, there were no differences between the urinary US levels of patients with pituitary adenoma and patients with adrenal adenoma. Furthermore, no US was detected in the urine of patients with aldosteronism (two males and eight females aged 34 to 61 years).(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: 17-Ketosteroids; Adenoma; Adult; Aged; Chromatography, High Pressure Liquid; Cushing Syndrome; Female; Glucuronates; Humans; Ketosteroids; Male; Middle Aged; Pituitary Neoplasms; Reference Values

Adrenocortical carcinoma is a rare tumor with a poor prognosis. This work was aimed at analyzing the clinical outlook and treatment results of 52 patients with this disease.. This study included patients with adrenocortical carcinoma referred to the Department of Endocrinology at the Center of Postgraduate Medical Education (Warsaw, Poland) during the last 30 years. In 11 patients, the adrenal tumor was found incidentally by ultrasonographic scan. Hormonal examinations made it possible to define the endocrine activity of the tumors, whereas imaging techniques helped to determine their staging. Forty-eight patients underwent surgery, and 36 of them received mitotane. This drug was administered to 26 patients for a range of 10 months to 10 years; 13 patients received mitotane immediately after the operation, and 13 others after a delay. The patients with severe hypercorticism were pretreated before surgery with aminoglutethimide and mitotane.. The study comprised 10 men and 42 women; hormonally active tumors were diagnosed in 39 of them. Cushing's syndrome was the most frequent entity. At diagnosis, 17 cases were classified as localized disease, 15 as regional disease, and 20 as distant disease. Pretreatment with the inhibitors of steroidogenesis improved the survival perspectives in the early postoperative period. As of this writing, there were 12 survivors in the group of 26 patients treated by surgery and long term mitotane therapy and only 2 survivors of 7 patients treated with surgery only.. Surgery with immediate adjuvant long term mitotane administration was the most effective form of therapy for patients with adrenocortical carcinoma.

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adolescent; Adrenal Cortex Neoplasms; Adrenocortical Carcinoma; Adrenocortical Hyperfunction; Adult; Aged; Aminoglutethimide; Chemotherapy, Adjuvant; Cushing Syndrome; Female; Follow-Up Studies; Growth Hormone; Growth Hormone-Releasing Hormone; Humans; Hydrocortisone; Male; Middle Aged; Mitotane; Neoplasm Staging; Survival Rate; Testosterone; Treatment Outcome

A case of adrenocorticotropic hormone independent bilateral adrenocortical macronodular hyperplasia (AIMAH) is reported. A 59 year old male was admitted to hospital because of hypertension. Subsequently, hypercortisolism, low plasma adrenocorticotropic hormone (ACTH), loss of diurnal rhythm of ACTH, lack of suppression with high dose dexamethasone were found and bilateral adrenal enlargement was detected by abdominal computerized tomography and adrenal scintigraphy. Bilateral total adrenalectomy was performed under a diagnosis of bilateral adrenal hyperplasia associated with Cushing's syndrome. Both adrenal glands were enlarged in size and weight. Bulging nodules were found at the cut section. Microscopically, a variegated histologic pattern including trabecular, adenoid and zona glomerulosa-like (ZG-like) structures was revealed in the nodules. Immunohistochemical examination disclosed positive staining of cytochrome P-450 17 alpha, negative of 3 beta-HSD in the ZG-like structure. Ultrastructurally, the cells composing the ZG-like structure were similar to those of the ZG in normal adrenal cortex. The authors agree that AIMAH is one of the entities causing Cushing's syndrome, and advise pathologists to keep this disorder in mind when they examine the adrenals in Cushing's syndrome.

Topics: 17-Ketosteroids; Adrenal Cortex; Adrenocorticotropic Hormone; Cushing Syndrome; Cytochrome P-450 Enzyme System; Humans; Hyperplasia; Male; Microscopy, Electron; Middle Aged; Tomography, X-Ray Computed

Adrenal tumors showing no clinical manifestations (incidentaloma) are frequently encountered during imaging analysis upon routine examinations. These tumors are sometimes associated with hypertension and/or diabetes mellitus (DM). We have examined six cases of incidentalomas with these symptoms in this study. All patients underwent endocrinological evaluation by measuring plasma cortisol and aldosterone levels to assess adrenocortical function. The levels of urinary 17-hydroxysteroids, 17-ketosteroids and catecholamines were also measured. Imaging analysis were performed by using 131I-adosterol scintigraphy, computed tomography and magnetic resonance imaging. Whereas one case was diagnosed as having an adrenal adenoma without the examination of a surgical specimen, other cases underwent surgical removal of the tumor, and final diagnoses were made by pathohistological examination of the tumors. Three cases were diagnosed as having adrenocortical adenomas (one was functioning and others were non-functioning) and one case was diagnosed as having a functional adrenocortical carcinoma. Adenomas were found to produce either non-functional steroids or a small amount of functional steroid hormones. The adenoma patients all suffered hypertension, whereas one of the adenoma patients and the carcinoma patient showed signs of DM. By contrast, of the six cases, one case was diagnosed as having an adrenal cyst, and one case was diagnosed with myelolipoma. Although these two cases suffered DM and hypertension, respectively, it seemed to be unlikely that these clinical symptoms were caused by the adrenal disease. Thus, the present analysis of the six incidentaloma patients suggests that once an adrenal incidentaloma patient with hypertension and/or DM is found, both endocrinological and imaging examinations are necessary to determine the indication of surgical treatment. This analysis supports the present consensus that non-functional adenomas whose sizes are 3cm or less and whose sizes do not change at any reevaluation period, as well as adrenal cysts and myelolipoma should not be surgically removed.

Topics: 17-Ketosteroids; Adenoma; Adrenal Gland Neoplasms; Aged; Aldosterone; Carcinoma; Catecholamines; Cushing Syndrome; Diabetes Mellitus; Female; Humans; Hydrocortisone; Hydroxysteroids; Hypertension; Male; Middle Aged

Hirsutism in women is usually caused by benign adrenal or ovarian disorders, but it can also be caused by adrenal carcinoma. The most effective way to identify such carcinomas is not known.. We measured serum and urinary steroids before and after the administration of 3 mg of dexamethasone per day for five days in 14 hirsute women with histologically proved adrenal tumors (12 adrenal carcinomas and 2 adrenal adenomas) and in 73 women with hirsutism of non-neoplastic origin.. All the women with adrenal tumors had elevated basal serum concentrations of testosterone or dehydroepiandrosterone sulfate, as compared with 36 of the 73 women with non-neoplastic hirsutism (sensitivity, 100 percent; 95 percent confidence interval, 77 to 100; specificity, 50 percent; 95 percent confidence interval, 38 to 62). After the administration of dexamethasone, serum dehydroepiandrosterone sulfate concentrations and urinary 17-ketosteroid excretion decreased to values similar to those in normal women in all the women with non-neoplastic hirsutism, but in none of the 12 with adrenal tumors who were tested. All the women who did not have adrenal tumors had serum cortisol concentrations below 3.3 micrograms per deciliter (90 nmol per liter) after dexamethasone administration, whereas in all 12 patients tested who had tumors the values were higher. The suppression of serum dehydroepiandrosterone sulfate and cortisol and urinary 17-ketosteroid excretion excluded the likelihood of adrenal tumors with a sensitivity of 100 percent (95 percent confidence interval, 74 to 100) and a specificity of 100 percent (95 percent confidence interval, 89 to 100).. Among women with hirsutism, an adrenal tumor is unlikely if the patient has normal basal serum concentrations of testosterone and dehydroepiandrosterone sulfate. In women in whom these concentrations are elevated, a tumor is unlikely if the serum concentration of dehydroepiandrosterone sulfate and urinary 17-ketosteroid excretion are in the normal basal range and the serum cortisol concentration is less than 3.3 micrograms per deciliter after the administration of dexamethasone.

Topics: 17-Ketosteroids; Adenoma; Adolescent; Adrenal Gland Neoplasms; Adult; Androstenedione; Carcinoma; Cushing Syndrome; Dehydroepiandrosterone; Dehydroepiandrosterone Sulfate; Dexamethasone; Female; Follicle Stimulating Hormone; Hirsutism; Humans; Hydrocortisone; Luteinizing Hormone; Middle Aged; Reference Values; Testosterone

A unilateral adrenal tumour was incidentally detected in a 39-year-old woman with no characteristic features of Cushing's syndrome. Basal levels of glucocorticoids were within normal limits. However, abnormal pattern of plasma cortisol and ACTH was observed. The dexamethasone suppression test and the metyrapone test showed also abnormal response. Adrenocortical scintigram demonstrated high accumulation of the radiopharmaceutical in the tumour region alone. Final diagnosis was "pre-Cushing's syndrome" and a solitary adenoma was removed from the left adrenal gland.

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenal Gland Neoplasms; Adrenocortical Adenoma; Adrenocorticotropic Hormone; Adult; Aldosterone; Cushing Syndrome; Dexamethasone; Female; Humans; Hydrocortisone; Magnetic Resonance Imaging; Metyrapone; Tomography, X-Ray Computed

A previously unknown HPLC peak was recently observed in urine samples from patients with Cushing's syndrome and disease. We analysed dansylated derivatives of 17keto steroid glucuronides in urine samples from patients with Cushing's syndrome, Cushing disease and from healthy subjects using high-performance liquid chromatography (HPLC) on reversed-phase Cap Cell PakC8. All urine samples from patients with Cushing's syndrome caused by adrenal adenoma and Cushing's disease showed an unknown large peak at the point between [110HE-G] and [110HA-G] peaks and at a retention time of 25.4 min. The same unknown peak was also observed in urine samples from a patient with asymptomatic cortisol-producing adrenal adenoma and two patients with ectopic ACTH-producing tumor, though the peak height was low for the former and one of the latter but high for the second of the two patients. In contrast, healthy male and female urine only showed a very small peak at the same retention time. Urine samples from a Cushing disease treated with op'DDD and Cushing's syndrome bilaterally adrenalectomized and treating with cortisol showed no such peak. The retention time of this unknown peak is clearly different from that of seven 17keto steroid standard glucuronide conjugates. The structure of this substance may be closely related to [110HE-G] or [110HA-G].

Topics: 17-Ketosteroids; Adenoma; Adenoma, Basophil; Adrenal Gland Neoplasms; Adult; Androstane-3,17-diol; Chromatography, High Pressure Liquid; Cushing Syndrome; Female; Hormones; Humans; Male; Middle Aged; Pituitary Neoplasms

A 40-year-old white woman presented with hirsutism, amenorrhea, generalized fatigue, diffuse weight gain, acral changes, and coarsened facial features. Physical examination revealed mild diastolic hypertension, acromegalic features, hirsutism, and seborrhea. The growth hormone concentration was elevated and did not suppress after glucose administration. Urinary free cortisol excretion was increased and was not suppressed during a 2 mg low-dose dexamethasone suppression test. Magnetic resonance imaging of the sella demonstrated a 1.3 x 1.2 x 0.8 cm pituitary adenoma. Trans-sphenoidal resection was performed, and portions of the resected tumor were analyzed by routine pathologic methods. Histopathologic and immunohistochemical findings indicated discrete growth hormone- and adrenocorticotropic hormone-producing pituitary adenomas. Coexisting acromegaly and Cushing's syndrome due to pituitary neoplasia was previously reported in two patients. However, to the authors' knowledge, this represents the first description of a patient with acromegaly and Cushing's disease resulting from discrete synchronous adenomas of the pituitary gland as defined by modern histopathologic techniques.

Topics: 17-Ketosteroids; Acromegaly; Adenoma; Adult; Cushing Syndrome; Dehydroepiandrosterone; Dehydroepiandrosterone Sulfate; Dexamethasone; Female; Hirsutism; Humans; Hydrocortisone; Magnetic Resonance Imaging; Pituitary Neoplasms; Reference Values; Testosterone

The content of GABA was measured in blood plasma of 111 patients suffering from Itsenko-Cushing disease. In untreated females, the blood GABA content was noticeably lowered; during treatment it increased, reaching normal, on the average, in patients with a history of total adrenalectomy. The changes in the blood GABA content in male patients were marked to a less degree. In the persons with a history of total adrenalectomy the GABA content turned out higher than normal. The blood GABA content in patients was dependent on the age and disease standing. In males experiencing disease exacerbation, it was appreciably reduced. As compared to females, the degree of a negative correlation between the blood content of GABA and ACTH (or cortisol) in males was more pronounced. The correlation between the excretion of 17-HCS with urine and GABA blood content in men and women was reverse. Women manifested a positive correlation between the excretion of 17-HCS with urine and blood GABA content, whereas men between arterial pressure and blood GABA. The problem of potential disorders of the GABAergic brain system in patients afflicted with Itsenko-Cushing disease is under discussion.

Topics: 11-Hydroxycorticosteroids; 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenalectomy; Adrenocorticotropic Hormone; Adult; Chromatography, Ion Exchange; Chronic Disease; Combined Modality Therapy; Cushing Syndrome; Female; gamma-Aminobutyric Acid; Humans; Hydrocortisone; Male; Middle Aged

A 33 year old woman presented with recurrent Cushing's disease 4 years after complete remission induced by pituitary surgery. On relapse she exhibited the unusual pattern of elevated indices of cortisol secretion with markedly suppressed serum DHEA-S; urinary 17-ketosteroid excretion was also below the normal range. Biochemical testing was otherwise consistent with ACTH-mediated hypercortisolism, and adrenal histopathology showed bilateral hyperplasia with no evidence of tumor. This case illustrates that serum DHEA-S is not an infallible guide to the differential diagnosis of Cushing's syndrome, and it supports the existence of a pituitary-secreted adrenal androgen stimulating factor that is distinct from ACTH.

Topics: 17-Ketosteroids; Adrenal Glands; Adrenocorticotropic Hormone; Adult; Androgens; Cushing Syndrome; Dehydroepiandrosterone; Dehydroepiandrosterone Sulfate; Female; Humans; Hydrocortisone; Recurrence

A generation ago, the determination of urinary 17-hydroxycorticoids was the best available laboratory procedure for assessing adrenocortical function. Today, the plasma cortisol concentration, measured by radioimmunoassay, is a much more specific and reliable parameter, particularly in combination with simple functional tests, which are also suitable for ambulatory patients. The most appropriate tests of adrenocortical function for the diagnosis or exclusion of Cushing's syndrome or of primary and secondary adrenocortical failure are briefly described. Substitution therapy in patients with adrenocortical insufficiency must be evaluated by clinical criteria and not by steroid analysis.

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenal Cortex Diseases; Adrenal Cortex Function Tests; Adrenal Insufficiency; Adrenocorticotropic Hormone; Cushing Syndrome; Dexamethasone; Humans; Hydrocortisone; Radioimmunoassay

We present nine cases of primary adrenocortical carcinoma, collected in our department of medicine and endocrinology over 25 years. In our patients, the most dependable tumor marker was urinary excretion of tetra-hydro-ll-deoxycortisol (THS), and elevated values were found in all cases where it was determined. In addition to surgical treatment, medication with o,p'-DDD was found to be of value for some of the patients. Median tumor weight was 487 g (118-2,085 g). Prognosis is difficult to predict. Median survival time after diagnosis was 34 months, but varied from three to 266 months.

Topics: 17-Ketosteroids; Adrenal Cortex Neoplasms; Adult; Aged; Biomarkers, Tumor; Cortodoxone; Cushing Syndrome; Female; Humans; Hydrocortisone; Male; Middle Aged; Mitotane; Neoplasm Metastasis; Prognosis

We describe thirty-one patients with Cushing's syndrome, with the object of evaluating the relative merit of the Dexamethasone suppression test, Metyrapone test and Corticotrophin Releasing Factor (CRF) test in classifying the syndrome. Bilateral adrenocortical hyperplasia (Cushing's disease) was present in sixteen patients. Three had bilateral macrodular hyperplasia of the adrenal cortex, six had adrenocortical adenoma, four had adrenocortical carcinoma, and two patients presented ectopic ACTH-syndrome. The diagnosis was surgically verified in every case. The Metyrapone test was found to give the safest classification in patients with Cushing's syndrome. The Dexamethasone test will diagnose Mb. Cushing reliably when suppression of serum cortisol is present following the large dose of Dexamethasone, but failure to suppress does not exclude the diagnosis. The CRF test is easy to perform and distinguished reliably between Mb. Cushing and other causes of the syndrome in eight out of ten patients in whom it was performed. Outpatient examination including the CRF test and CT-scanning of the pituitary and adrenal glands is advocated as a preliminary step in the classification of biochemically and clinically suspected cases of Cushing's syndrome.

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adolescent; Adrenocorticotropic Hormone; Adult; Aged; Corticotropin-Releasing Hormone; Cushing Syndrome; Dexamethasone; Female; Humans; Hydrocortisone; Male; Metyrapone; Middle Aged

We describe a direct method for determining four sulfates and seven glucuronides of 17-oxosteroids (17OS) in urine without hydrolysis, by use of "high-performance" liquid chromatography (HPLC) with fluorometric detection. After pretreatment of urine samples with a Sep-Pak C18 cartridge, four 17OS sulfates and seven 17OS glucuronides in the pretreated urine samples were reacted with tetrapentylammonium ions to form ion pairs. Ion-paired 17OS sulfates were extracted with benzene. By adding sodium sulfate to the remaining sample, we could then extract ion-paired 17OS glucuronides with dichloromethane. Each extract was labeled with dansyl-hydrazine in an acetic acid-acetonitrile solution. The labeled steroids were separated by HPLC on a reversed-phase Capcell-Pak C8 (silicon-polymer-coated silica gel modified with octyl groups). We monitored each effluent with a fluorometric detector (330 nmexcitation, 535 nmemission).

Topics: 17-Ketosteroids; Chromatography, High Pressure Liquid; Cushing Syndrome; Dansyl Compounds; Fluorometry; Glucuronates; Humans; Hydrazines; Hydrogen-Ion Concentration; Hyperaldosteronism; Male; Quaternary Ammonium Compounds; Solvents; Sulfates

Evaluation of the clinical and biochemical parameters for differential diagnosis of two types of Cushing's syndrome, pituitary-dependent Cushing's disease and adrenal adenoma, was studied with analysis of the histories of 79 cases of Cushing's disease and 23 cases of adrenal adenoma. The data show that the symptoms, signs and the routine biochemical analyses were not significantly different between two groups. High-dose dexamethasone suppression test had about 90% coincidence rate in the differential diagnosis with 24-hour urine free cortisol (UFC), which was better than 24-hour urine 17-OHCS. Interestingly, low-dose dexamethasone test was highly valuable and the 24-hour urine 17-KS quite helpful in the differential diagnosis of two types of Cushing's syndrome. Serum N-POMC measurement was the most valuable among the parameters, because there was no overlap between the two groups of Cushing's syndrome.

Topics: 17-Ketosteroids; Adenoma; Adrenal Gland Neoplasms; Adult; Cushing Syndrome; Dexamethasone; Diagnosis, Differential; Female; Humans; Hydrocortisone; Male; Peptide Fragments; Pro-Opiomelanocortin

A 48-year-old man was admitted for treatment of Cushing's syndrome due to right adrenal adenoma, associated with chronic renal failure (CRF) with a blood urea nitrogen level of 64.2 and serum creatinine level of 3.9 mg/dl. After removal of the adrenal adenoma, the CRF deteriorated with progressive symptoms of anorexia, vomiting and hypertension, and the patient was placed on hemodialysis. Prior to adrenalectomy, the 17 OHCS and 17 KGS in the urine were not so high. However, the urinary 17 KS was high with an elevated 11-oxy fraction. In comparison with 2 patients suffering from adrenal Cushing's syndrome with normal renal function, there were no large accumulated quantities of glucuronic conjugated and unconjugated metabolites in the plasma of the CRF Cushing's syndrome, with confirmation ascribable to the radioimmunoassayable cross-reactivity of the cortisol antiserum used in the radioimmunoassay kit. In the Cushing's syndrome with CRF, almost all the cortisol, which was hypersecreted from the adenoma, was presumed to be converted to the 11-oxy fraction of 17 KS, possibly by activation of hepatic enzymes.

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adenoma; Adrenal Gland Neoplasms; Adult; Cushing Syndrome; Female; Humans; Hydrocortisone; Kidney Failure, Chronic; Male; Middle Aged

We determined glucocorticoid receptors in human mononuclear leukocytes in 9 patients with Cushing's disease, in order to correlate them with laboratory data. Receptors were measured by a whole-cell assay method, after incubation with [3H]-dexamethasone in the presence or absence of excess unlabelled hormone. In Cushing's disease, there were 4425 +/- 364 sites/cell (N = 9), similar to in the controls: 4473 +/- 476 (N = 10); average Kd was 2.42 +/- 0.52 nmol/l (N = 3) similar to in the controls: 2.0 +/- 0.20 nmol/l (N = 3). In Cushing's patients we found significant negative correlations between basal glucocorticoid receptors and: 1) morning blood cortisol (r = -0.67, P less than 0.05), and 2) 17-ketogenic steroids after 2 mg of dexamethasone (r = -0.85, P less than 0.01). No correlations were observed with afternoon blood cortisol, free urinary cortisol, basal and post-8-mg dexamethasone 17-ketogenic steroids, TRH-TSH area, urinary calcium, plasma glucose, or systolic blood pressure.. In Cushing's disease, a subtle receptor down-regulation may exist, as suggested by the inverse relationship between glucocorticoid receptors and morning blood cortisol. Secondly, the relationship between basal receptors and 17-ketogenic steroids after 2 mg of dexamethasone suggests that glucocorticoid receptors in human mononuclear leukocytes could reflect the sensitivity of the nervous system-pituitary-adrenal axis to dexamethasone inhibition.

Topics: 17-Ketosteroids; Adolescent; Adult; Calcium; Cushing Syndrome; Dexamethasone; Female; Humans; Hydrocortisone; Leukocytes, Mononuclear; Male; Middle Aged; Receptors, Glucocorticoid; Thyrotropin

Periodic hormonogenesis has been described in patients with ACTH-dependent hypercorticism, and fluctuations of cortisol secretion have also been observed in patients with adrenal tumors. In this report, we studied a 41-year-old white male who presented with hypertension, central obesity, and muscle weakness of 2-years duration. His plasma cortisol was low (4.5 micrograms) in the morning and high in the evening (29.3 micrograms). Urinary free cortisol was 750 micrograms/day. A 24-hour cycle demonstrated highest values at noon and in late afternoon. This pattern was not suppressed by dexamethasone. When the patient was kept fasting, plasma cortisol remained low all day, and became elevated immediately after meal administration overnight. A left-sided adrenal mass was demonstrated and removed. In vitro, the adenylate cyclase activity of tumor tissue demonstrated more significant response to vasopressin than to ACTH; other tested peptides were inactive. We propose that a humoral factor induced by eating was responsible for the periodic hormonogenesis, directly stimulating the adrenal secretion of cortisol.

Topics: 17-Ketosteroids; Adrenocorticotropic Hormone; Adult; Circadian Rhythm; Cosyntropin; Cushing Syndrome; Dexamethasone; Drug Administration Schedule; Eating; Fasting; Humans; Hydrocortisone; Male

The analysis of 24-h excretion profiles of urinary steroids in 18 patients suffering from Cushing's syndrome or adrenocortical tumors revealed typical patterns when compared to 37 healthy control persons, 24 patients with obesity, and 6 patients with hirsutism. The validation of eight criteria--increased excretion of free cortisol, 6 beta-hydroxycortisol, 20 alpha-dihydrocortisol, 11 beta-hydroxyandrosterone, and 3 beta-hydroxy-5-en steroids, decreased ratio of tetrahydrocortisone (THE) to tetrahydrocortisol (THF), and increased ratios of THF to allotetrahydrocortisol (a-THF) and metabolites of androgens (AM) to metabolites of cortisol (CM)--afforded reliable detection of disorders in steroid biosynthesis. The analysis of urinary steroid profiles can therefore be recommended as a screening procedure in patients with clinical symptoms of disorders in steroid production and/or metabolism.

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adolescent; Adrenal Cortex Neoplasms; Adrenocorticotropic Hormone; Adult; Child; Cushing Syndrome; Female; Humans; Hydrocortisone; Male

The experience with adrenocortical neoplasms in childhood is reviewed. During three decades, ten children with adrenocortical neoplasms were seen at the authors' institution. The literature was reviewed, and 209 patients 16.5 years or younger were found. All ten patients at Vanderbilt University Hospital (VUH) presented with endocrine manifestations of the tumor. Three patients had Cushing's, two patients had virilization, and five patients had features of both. In the literature, virilization, alone or with Cushing's, was the most common mode of presentation. Feminizing tumors were uncommon and nonfunctional tumors rare. The majority of patients were female. Features associated with malignancy included 17-KS levels greater than 40 mg/24 hr, diameter greater than 6 cm, weight greater than 500 g, and histologic evidence of diffuse growth pattern, vascular invasion, and tumor cell necrosis. Although uncommon, adrenocortical neoplasms should be suspected in children with Cushing's, virilization, feminization, or a combination of these. There has been an increased incidence reported in patients with hemihypertrophy, Beckwith-Wiedemann syndrome, hemangiomas, and nevi. Following endocrinologic evaluation, imaging studies should be performed. CT scan appears to be the most useful diagnostic tool. A posterior operative approach is recommended for suspected adenomas. An anterior thoracoabdominal approach is favored for suspected malignancies with uncompromised en bloc resection. There is no evidence that adjuvant therapy provides any additional benefit.

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adenoma; Adolescent; Adrenal Cortex Neoplasms; Carcinoma; Child; Child, Preschool; Cushing Syndrome; Female; Hirsutism; Humans; Hypertrophy; Infant; Male; Prognosis

A 57-year-old woman was demonstrated to be affected by adrenocorticotropic hormone (ACTH)-independent Cushing's syndrome. Computed-axial tomography of the abdomen demonstrated an expansion of the left adrenal. In apparent contrast with these findings, adrenal scintigraphy demonstrated radiocholesterol uptake also by the right gland. At surgery, the left adrenal was found to be hard and enlarged and was excised, while the right gland was found of normal appearance and left in place. Histologic examination of the excised gland demonstrated nodular hyperplasia. Early after surgery, plasma cortisol returned to normal values with a normal circadian rhythm and complete inhibition by low dose dexamethasone; the response of plasma cortisol to ACTH was normal. The patient represents a rare case of unilateral adrenal nodular hyperplasia. Radiocholesterol uptake by the contralateral gland and early recovery from adrenal atrophy after surgery are exceptional findings and suggest incomplete inhibition of endogenous ACTH.

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenal Glands; Adrenalectomy; Adrenocorticotropic Hormone; Circadian Rhythm; Cushing Syndrome; Dexamethasone; Female; Humans; Hydrocortisone; Hyperplasia; Middle Aged; Radionuclide Imaging; Tomography, X-Ray Computed

The therapeutic value of ketoconazole for long term treatment of patients with Cushing's syndrome was studied. Seven patients with Cushing's disease and one with an adrenal adenoma received 600-800 mg/day ketoconazole for 3-13 months. Plasma ACTH, cortisol, and dehydroepiandrosterone sulfate levels and urinary cortisol, 17-ketosteroid, and tetrahydro-11-deoxycortisol excretion were determined periodically during the treatment period. Plasma ACTH and cortisol responses to CRH stimulation were determined before and during treatment. Rapid and subsequently persistent clinical improvement occurred in each patient; plasma dehydroepiandrosterone sulfate and urinary 17-ketosteroid and cortisol excretion decreased soon after the initiation of treatment, subsequently remaining normal or nearly so throughout the treatment period. Urinary tetrahydro-11-deoxycortisol excretion increased significantly. Plasma cortisol levels decreased. Plasma ACTH levels did not change, and individual plasma ACTH and cortisol increments in response to CRH were comparable before and during treatment. The cortisol response to insulin-induced hypoglycemia improved in one patient and was restored to normal in another. The seven patients tested recovered normal adrenal suppressibility in response to a low dose of dexamethasone during ketoconazole treatment. Ketoconazole is effective for long term control of hypercortisolism of either pituitary or adrenal origin. Its effect appears to be mediated by inhibition of adrenal 11 beta-hydroxylase and 17,20-lyase, and it, in some unknown way, prevents the expected rise in ACTH secretion in patients with Cushing's disease.

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adolescent; Adrenocorticotropic Hormone; Adult; Cushing Syndrome; Dehydroepiandrosterone; Dehydroepiandrosterone Sulfate; Dexamethasone; Female; Humans; Hydrocortisone; Ketoconazole; Male; Middle Aged; Time Factors

In a patient with proved pituitary-dependent Cushing's syndrome (Cushing's disease), 24-hour urinary excretion of free cortisol fluctuated between normal (69 percent of the time, often in the low range and for several days in sequence) and high values. Increased urinary free cortisol excretion occurred unpredictably within the context of a persistent, progressive clinical picture. This case stands in contrast with previous reports of urinary steroid levels varying in a periodic infradiem pattern. Even with normal baseline cortisol indexes, control of the hypothalamic-pituitary axis (as indicated by the suppression test and by the circadian cortisol pattern in plasma) remained abnormal. This patient emphasizes the fact that abnormal control regulation, more than cortisol hypersecretion, is at times indicative of Cushing's disease. Hence, sensitive accurate screening requires not only urinary free cortisol measurement (the usefulness of which may be improved by assay of more than one, possibly nonsequential, 24-hour urine sample), but also dexamethasone suppression testing and late-evening plasma cortisol determination, even if baseline indexes are within the range of normal.

Topics: 17-Ketosteroids; Adult; Cushing Syndrome; Dexamethasone; False Negative Reactions; Female; Humans; Hydrocortisone; Hypothalamo-Hypophyseal System

Recently, ketoconazole, an imidazole derivative with antifungal properties, has been shown to inhibit adrenal corticosteroid and androgen production. We treated a patient with small-cell lung cancer and Cushing's syndrome secondary to ectopic secretion of adrenocorticotropic hormone in whom it was necessary to discontinue chemotherapy. The patient was treated with ketoconazole, with a resultant reduction in urinary free cortisol and ketosteroid excretion and improvement in electrolyte balance. Ketoconazole may be a useful adjunct in the treatment of small-cell lung cancer or other malignancies associated with excessive corticosteroid production or as a hormonal therapy in breast or prostatic cancer.

Topics: 17-Ketosteroids; Adrenocorticotropic Hormone; Carcinoma, Small Cell; Cushing Syndrome; Humans; Hydrocortisone; Ketoconazole; Lung Neoplasms; Male; Middle Aged; Potassium

A 47-year-old woman affected by Cushing's syndrome due to an adrenal adenoma is described. An altered but rhythmometrically apparent cortisol secretory rhythm was detected using the single-cosinor computation. In fact serum cortisol levels and urinary excretion of 17-OHCS were elevated in the PM hours, particularly between 14:00-18.00 h and 18:00-22:00 h, and normal between 02:00-10:00 h. The patient was cured by unilateral adrenalectomy and one year later the circadian rhythm of corticosteroids secretion was investigated again. A normal rhythm of cortisol secretion and of 17-OHCS urinary excretion was found. Though it may be hypothesized that factors intrinsic to the tumoral adrenal cells were responsible for the rhythmic, but phase-shifted, hormonal release, the cause of the persistent and abnormal cortisol secretory rhythm is unknown.

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adenoma; Adrenal Cortex Neoplasms; Adrenalectomy; Adrenocorticotropic Hormone; Circadian Rhythm; Cushing Syndrome; Female; Glucocorticoids; Humans; Hydrocortisone; Hypothalamo-Hypophyseal System; Middle Aged; Pituitary-Adrenal System; Time Factors

Six chronic alcoholics with stigmata of Cushing's syndrome were studied before and after a period of alcohol abstinence. In all of them, after a minimum period of 3-4 weeks, a marked clinical and laboratory improvement was noted. The authors suggest that damage at brain level, with neurotransmitters' disturbance, caused by chronic alcoholism underlies the Pseudo-Cushing's Syndrome. The primum movens could be a disorder of the pituitary-adrenal axis secondary to a dysfunction of neurotransmitters with stimulation of ACTH-secreting cells of the adenohypophysis by the certicotropin-releasing factor (CRF).

Topics: 11-Hydroxycorticosteroids; 17-Ketosteroids; Adolescent; Adrenocorticotropic Hormone; Adult; Alcoholism; Corticotropin-Releasing Hormone; Cushing Syndrome; Dexamethasone; Female; Humans; Hydrocortisone; Male; Radioimmunoassay

Effects of o,p'-DDD on parameters of cortisol metabolism were studied in 3 patients with Cushing's syndrome (ectopic ACTH-syndrome, Cushing's disease, and adrenal cancer). Before o,p'-DDD treatment, plasma cortisol, urinary 17OHCS, and urinary free cortisol were elevated in all patients. These parameters correlated well with each other in ectopic ACTH-syndrome and Cushing's disease. However, in adrenal cancer, urinary 17OHCS did not correlate with either plasma cortisol or urinary free cortisol, while the latter two parameters did. During o,p'-DDD, urinary 17OHCS rapidly declined in a patient with ectopic ACTH syndrome and a patient with Cushing's disease before plasma cortisol or urinary free cortisol decreases. Consequently the positive correlations of urinary 17OHCS with the other parameters were lost. In a case of adrenal cancer, urinary 17OHCS again did not correlate with plasma cortisol or urinary free cortisol. In these conditions, plasma cortisol and urinary free cortisol still significantly correlated. The present results demonstrated the limit of urinary 17OHCS as the index of the cortisol secretion rate both in some cases of adrenal cancer and in patients taking o,p'-DDD. It is suggested that urinary free cortisol should be utilized as a more accurate index for the cortisol secretion rate in such circumstances.

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adenoma; Adrenal Gland Neoplasms; Adrenocorticotropic Hormone; Adult; Carcinoid Tumor; Cushing Syndrome; Female; Humans; Hydrocortisone; Male; Middle Aged; Mitotane; Pituitary Neoplasms; Radioimmunoassay; Thymus Neoplasms

A case of adrenal carcinoma with Cushing's syndrome was presented. Endocrinological and morphological investigations disclosed the presence of a functional adrenal carcinoma. This case was characterized by its unusual urinary 17-ketosteroid (17-KS) fractionation, i.e. a marked elevation of 17-KS was accompanied by the increments of etiocholanolone, but not of dehydroepiandrosterone (DHEA) or androsterone. Measurements of the plasma adrenocorticosteroids revealed normal DHEA and DHEA-S (sulfate) levels, moderately increased 17-OH-pregnenolone, and markedly increased (less than 100 times the normal) 11-deoxycortisol (cpd S). Therefore, it seems plausible that the normal urinary DHEA level in this patient would have occurred as a result of remarkably low C17-20 lyase activity sufficient to hamper DHEA production, and that markedly increased etiocholanolone might possibly have been converted from cpd S as well as from DHEA and androstenedione through 5 beta-reduction.

Topics: 17-alpha-Hydroxypregnenolone; 17-Ketosteroids; Adrenal Cortex Neoplasms; Adult; Androstenedione; Androsterone; Cortodoxone; Cushing Syndrome; Dehydroepiandrosterone; Dehydroepiandrosterone Sulfate; Etiocholanolone; Humans; Male; Tomography, X-Ray Computed

Previously in world literature there have been reports of 40 pregnancies in women with untreated Cushing's syndrome. The perinatal mortality in these series has been 12.9%. This paper reports on a case in which low serum oestriol excretion was the first abnormal laboratory value in a patient with only a few signs of Cushing's syndrome habitus and adrenal adenoma.

Topics: 17-Ketosteroids; Adenoma; Adrenal Gland Neoplasms; Adult; Cushing Syndrome; Estriol; Female; Humans; Hydrocortisone; Pregnancy; Pregnancy Complications

Seventeen patients with adrenal adenoma causing Cushing's syndrome, eight patients with Cushing's disease due to hypersecretion of ACTH, and five patients with primary aldosteronism due to an aldosteronoma were studied for their computed tomographic (CT) patterns, hormonal profiles, and macroscopic and microscopic findings of the adrenal gland. Black (or brown) adrenal adenomas were found in 71% of the patients with Cushing's syndrome, but not in patients with aldosteronoma. The adrenal tissue of patients with Cushing's disease was predominantly yellow. The number of compact cells was larger in black or brown adenomas than in yellow tumors or hyperplastic adrenal tissue. In patients with Cushing's syndrome, urinary excretion of 17-ketosteroids (17-KS) and serum aldosterone concentrations were lower in those with black or brown adenomas than in those with yellow adenomas (P less than 0.05). Patients with Cushing's disease had even higher 17-KS and serum aldosterone levels. No difference was found in serum cortisol concentrations and dexamethasone suppressibility in two types of adenomas causing Cushing's syndrome. Visual estimation of radiological density of the adrenal tissue relative to the kidney on CT scan and quantitative measurement of it by CT number revealed a difference between the two types of adrenal tumors causing Cushing's syndrome. Adrenal tumors with decreased density on CT scan were yellow adenomas with predominantly clear cells, and those with equal or increased density were black or brown adenomas with predominantly compact cells. All aldosteronomas had decreased density and consisted of clear cells. It is suggested that black or brown adenomas of the adrenal gland have higher radiological density and accompanying lower serum aldosterone and urinary 17-KS levels than ordinary yellow tumors. The abundance of compact cells may have some significance for the development of this particular type of adrenal tumor.

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adenoma; Adolescent; Adrenal Cortex Neoplasms; Adult; Aldosterone; Color; Cushing Syndrome; Female; Humans; Hydrocortisone; Male; Microscopy, Electron; Middle Aged; Tomography, X-Ray Computed

Four patients with Cushing's disease were treated with bromocriptine, administered three times daily, in doses ranging from 7.5 to 15 mg/day, during an average period of 80 days. Daily urinary 17-hydroxycorticosteroids (17-OHCS) and 17-ketosteroids (17-KS) excretion was measured during dynamic tests and at two-week intervals. Plasma adrenocorticotropic hormone (ACTH) and cortisol levels were also assayed before and after therapy. A marked clinical and laboratory improvement was noted in two patients, in another some clinical and laboratory improvement was obtained only after bromocriptine dosage was increased to 15 mg/day. There was no effect in the fourth patient. Thus, at least for a short period of time, bromocriptine may be useful therapy for some patients with Cushing's disease.

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adolescent; Adrenocorticotropic Hormone; Adult; Bromocriptine; Cushing Syndrome; Dexamethasone; Female; Humans; Hydrocortisone; Male; Metyrapone

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenal Glands; Adrenocorticotropic Hormone; Adult; Aged; Cushing Syndrome; Dexamethasone; Female; Humans; Hydrocortisone; Male; Middle Aged; Radionuclide Imaging

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adenoma; Adolescent; Adrenal Gland Neoplasms; Adult; Carcinoma; Cushing Syndrome; Female; Humans; Hydrocortisone; Infant; Male; Middle Aged

Cushing's syndrome was diagnosed in a 14 year old girl and, 5 years later, in her nephew (sister's son) also when he was 14 years of age. Administration of tetracosactid (Synacthen) did not stimulate adrenocortical function in either patient, nor did dexamethasone suppress the elevated urinary steroids in the girl, and only partially suppressed them in the boy. Both patients were adrenalectomized and made an uneventful recovery. The surgical specimens were identical both on gross inspection and histologically, showing the typ ical morphological features of pigmented multinodular adrenocortical dysplasia. We believe that this lesion represents an inherited adrenocortical maldevelopment (rather than true neoplasia) leading to an autonomous adrenocortical hyperfunction which typically manifests itself clinically during adrenarche (i.e. functional adrenocortical maturation) at the beginning of puberty. Family Cushing's syndrome, caused by pigmented multinodular adrenocortical dysplasia, represents a disease entity.

Topics: 17-Ketosteroids; Adolescent; Adrenal Cortex; Adrenalectomy; Child; Cosyntropin; Cushing Syndrome; Dehydroepiandrosterone; Dexamethasone; Female; Humans; Hydrocortisone; Pigments, Biological

A 35-yr-old woman had Cushing's syndrome, amenorrhea, and elevated and nonsuppressible levels of urinary and plasma cortisol and urinary 17-hydroxycorticosteroids. An ovarian carcinoma with extensive metastases was found. Tumor concentrations of ACTH were much lower than those in any previously reported patient with the ectopic ACTH syndrome. Cortisol levels obtained from the venous effluent of tumor-involved ovaries were higher than that in peripheral plasma obtained at the same time. Transient postoperative normalization of plasma and urinary cortisol followed partial tumor removal. Electron microscopic study of the tumor revealed a cell type consistent with steroid-secreting cells. Postmortem examination revealed atrophy of both adrenal glands and no pituitary adenoma.

Topics: 17-Ketosteroids; Adrenal Glands; Adrenocorticotropic Hormone; Adult; Atrophy; Cushing Syndrome; Dexamethasone; Female; Humans; Hydrocortisone; Hydroxysteroids; Ovarian Neoplasms

Forty-three patients were treated by total adrenalectomy for pituitary-dependent Cushing's disease. The median period of observation was 10 years (range one to 20 years). Thirty-eight patients (88 per cent) had rapid and lasting remissions. Of the 38 in remission, 21 became pigmented but without pituitary enlargement, 11 became pigmented with evidence of further pituitary expansion (Nelson's syndrome) and six neither became pigmented nor showed pituitary expansion. Pituitary expansion was associated with high plasma ACTH values, and treatment of pituitary tumours by surgery or radiotherapy gave poor results. However, when compared with alternative methods of treatment, total adrenalectomy for Cushing's disease is still satisfactory for many patients, despite advances in pituitary surgery, and has advantages over 'medical adrenalectomy' with drugs.

Topics: 17-Ketosteroids; Adrenalectomy; Adrenocorticotropic Hormone; Adult; Cushing Syndrome; Female; Follow-Up Studies; Humans; Hydrocortisone; Male; Middle Aged; Nelson Syndrome; Postoperative Complications

Topics: 17-Ketosteroids; Adult; Cushing Syndrome; Female; Humans

Topics: 17-Ketosteroids; Adenocarcinoma; Adrenal Cortex Neoplasms; Adult; Carcinoma; Cushing Syndrome; Female; Humans; Middle Aged

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adolescent; Adult; Cushing Syndrome; Dexamethasone; Diagnosis, Differential; Female; Humans; Hydrocortisone; Polycystic Ovary Syndrome; Virilism

A 28 year old white women was found to have a cervical tumor in the 25th week of pregnancy. Pathologic examination revealed a nonkeratinizing small cell carcinoma. After delivery by cesarean section, pelvic lymph node exploration was carried out, and all 15 nodes were free of tumor. Her condition was staged as II-A, and she was treated with local radiation. Metastatic disease became manifest almost a year later and was histologically similar to her primary disease. A Cushingoid appearance was noticed and plasma cortisol levels were elevated. Twenty-four hour urinary 17-hydroxycorticosteroid (17-OHCS) and 17-ketosteroid (17-KS) levels were elevated and failed to suppress with dexamethasone. Plasma adrenocorticotropin (ACTH) level was elevated. Electron microscopic examination of the tumor tissue revealed neurosecretory granules. Immunoperoxidase stains for ACTH were positive. The patient's course was one of progressive decline and eventual death. A literature review revealed two other cases in which carcinoma of the uterine cervix was considered to be the source of ectopic ACTH. Some small cell carcinomas of the cervix may arise from cells of the APUD series. Small cell carcinoma of the uterine cervix may behave differently from the more commonly encountered keratinizing and large cell nonkeratinizing carcinomas of the cervix and may not respond as well to standard therapy. Ectopic hormone production, production of abnormal peptides or of vasoactive amines may be more common in small cell carcinoma of the cervix than is currently recognized, and these products may be clinically useful as tumor markers.

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; ACTH Syndrome, Ectopic; Adult; APUD Cells; Carcinoma; Cushing Syndrome; Female; Humans; Hydrocortisone; Paraneoplastic Endocrine Syndromes; Pregnancy; Pregnancy Complications; Uterine Cervical Neoplasms

Recent reports of patients with Cushing's disease who have been explored via the transsphenoidal route indicate that the great majority has pituitary adenomas. We report a patient with biochemically documented pituitary-based hypercortisolism who had a clinical and biochemical remission following hypophysectomy. Serial sections of the pituitary tissue removed showed hyperplasia of corticotroph cells but no adenoma. Hypophysectomy was complete as documented by serum levels of FSH, LH, TSH, prolactin, hGH and ACTH at the lower limits of the respective assays, with no response to appropriate stimuli. This case demonstrates that a minority of patients with Cushing's disease has corticotroph cell hyperplasia without a pituitary adenoma.

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenocorticotropic Hormone; Adult; Chorionic Gonadotropin; Cushing Syndrome; Female; Follicle Stimulating Hormone; Humans; Hyperplasia; Hypophysectomy; Luteinizing Hormone; Pituitary Gland; Pituitary Gland, Anterior; Prolactin; Thyrotropin

Cushing's syndrome was found in 2 of 4 siblings all of which also had other malformations. After bilateral adrenalectomy no hyperpigmentation was noted. Morphologically the adrenals of both siblings with Cushing's syndrome showed the typical lesions of the so-called microadenomatosis or primary adrenocortical nodular dysplasia with foci of eosinophilic giant cells. This is a new form of Cushing's syndrome due to an inborn error of the adrenals and no hypothalamic-pituitary dysfunction.

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adipose Tissue; Adrenal Cortex; Adrenalectomy; Adrenocorticotropic Hormone; Adult; Cushing Syndrome; Eosinophils; Humans; Hyperplasia; Male

A 15-yr-old girl was diagnosed as suffering from Cushing's disease. She was treated by bilateral adrenalectomy and autotransplantation of one third of each adrenal to the corresponding thigh. The adrenal that was embedded in the right satorius muscle started functioning after about 1 yr, as proven by significant differences in cortisol levels in both femoral veins (82.5 and 17.5 micrograms/100 ml). 19-[131I]Cholesterol scanning showed adrenal tissue in the right thigh, while no adrenal remnant was demonstrated. Eleven years after surgery, the patient is symptom free and does not require replacement therapy. We find that adrenal autotransplantation, which is a simple and nonrisky procedure, should be considered whenever bilateral adrenalectomy is chosen as a treatment for Cushing's disease.

Topics: 17-Ketosteroids; Adolescent; Adrenal Glands; Adrenalectomy; Cholesterol; Cushing Syndrome; Female; Humans; Hydrocortisone; Remission, Spontaneous; Transplantation, Autologous

Topics: 17-Ketosteroids; Adenoma; Adolescent; Adrenal Cortex; Adrenal Gland Neoplasms; Adrenalectomy; Adult; Child; Cushing Syndrome; Female; Humans; Hydrocortisone; Male; Pituitary Neoplasms; Pregnancy

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenocorticotropic Hormone; Cushing Syndrome; Cyproheptadine; Dexamethasone; Dopamine; Ergolines; Hydrocortisone; Metergoline; Pituitary Gland; Serotonin

Four post-menopausal women had Cushing's syndrome due to adrenal cortical carcinomas. Comprehensive analyses of blood and urinary steroids showed that although the steroid profiles differed between patients, the pattern in each patient remained almost constant as the disease progressed, or remitted due to therapy. Elevations of serum testosterone and oestradiol were commensurate with the extent of virilisation, and the urinary output of aldosterone was associated with the severity of hypertension. A new finding was that all had substantially increased urinary free deoxycorticosterone. Complete surgical removal of the primary tumours was impossible but when most of the tumour tissue was removed, full clinical and biochemical remissions were obtained for a short time in 2 patients. One patient obtained a clinical and biochemical remission from op'DDD. In another patient the drug caused reduction both in blood pressure and in urinary aldosterone excretion, but there were unpleasant side effects. A third patient could not tolerate op'DDD. Metyrapone therapy produced neither clinical nor biochemical improvement in 3 patients. The mean duration of survival was 17 months after the first symptoms and 10 months from the date of operation. Despite advances in drug therapy, adrenal cortical carcinoma remains a lethal disease. Biochemical screening of multiple steroids offers a means of early diagnosis and disease monitoring. Extensive surgical removal of the tumour offers the best chance of a clinical and biochemical remission.

Topics: 17-Ketosteroids; Adrenal Cortex Neoplasms; Adrenocorticotropic Hormone; Aldosterone; Carcinoma; Cortodoxone; Cushing Syndrome; Desoxycorticosterone; Electrolytes; Estradiol; Female; Humans; Hydrocortisone; Luteinizing Hormone; Metyrapone; Middle Aged; Mitotane; Pregnanetriol; Testosterone

Medullary carcinoma of the thyroid (MCT) is reported to synthesize ACTH. This ACTH is believed to be responsible for the development of Cushing's syndrome in some patients with MCT. To determine the frequency of occurrence of adrenal cortical overactivity in patients with MCT, we measured plasma cortisol concentration and the urinary excretion of 17-hydroxycorticosteroids, 17-ketosteroids and urinary free cortisol in 22 patients with MCT and 7 patients with MCT plus pheochromocytomas. The patients with MCT and MCT plus pheochromocytoma had similar adrenal cortical function to age and sex matched normal subjects. We conclude that adrenal cortical function is usually normal in patients with MCT.

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adolescent; Adrenal Cortex Function Tests; Adrenal Gland Neoplasms; Adrenocorticotropic Hormone; Adult; Carcinoma; Child; Cushing Syndrome; Female; Humans; Hydrocortisone; Male; Middle Aged; Pheochromocytoma; Thyroid Neoplasms

Plasma testosterone levels were suppressed in 6 of 8 mature male patients with Cushing's disease, all of whom complained of loss of libido and decreased sexual potency. Gonadotrophin levels, both under basal conditions and in response to LH-RH, were generally normal. The testicular response to stimulation with hCG was brisk in the 2 patients examined. Oestradiol levels were slightly elevated in 2 patients and prolactin levels were normal in all patients. Thus, male patients with Cushing's disease demonstrated normal gonadotrophin levels in the presence of suppressed testosterone, or, viewed from a slightly different prospect, low testosterone levels despite normal gonadotrophins. Neither oestradiol nor prolactin excess appeared to account for the observations. Possible explanations for these findings include (a) a combination of impaired hypothalamic and testicular function, and (b) a resetting downwards of the level of testosterone that is seen as appropriate by the disordered bypothalamic-pituitary unit. Following correction of cortisol excess in Cushing's disease, testosterone levels rose into the normal range.

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adult; Chorionic Gonadotropin; Cushing Syndrome; Estradiol; Follicle Stimulating Hormone; Gonadotropin-Releasing Hormone; Humans; Luteinizing Hormone; Male; Middle Aged; Prolactin; Testis; Testosterone

Basal values of the urinary excretion of 17-oxogenic steroids and serum levels of cortisol were not satisfactory in the differentiation of 'suspected' subjects from patients with true Cushing's syndrome. With an RIA method for serum cortisol determination, the overnight dexamethasone suppression test provided the most reliable single test in establishing adrenocortical hyperfunction. Thirty-five normal subjects, fifty-nine obese patients, thirteen 'suspected' patients, and thirteen patients with disease states other than Cushing's syndrome had suppressed values below 4.0 microgram/100 ml. None of the ten patients with Cushing's syndrome had a cortisol concentration less than 16.3 microgram/100 ml. Adrenal gland scintigraphy after radiocholesterol injection is a more valuable tool than the metyrapone test and the high-dose dexamethasone suppression test in the localization and differential diagnosis of adrenocortical lesions causing Cushing's syndrome. It obviates the need for angiographic procedure in the localization of adenomas. It is a reliable technique for identifying functioning adrenal remnants. We therefore propose a schedule for studying patients with suspected adrenocortical hyperfunction.

Topics: 17-Ketosteroids; Adolescent; Adrenal Cortex Function Tests; Adrenal Glands; Adult; Aged; Cosyntropin; Cushing Syndrome; Dexamethasone; Diagnosis, Differential; Female; Humans; Hydrocortisone; Male; Metyrapone; Middle Aged; Pituitary-Adrenal Function Tests; Radionuclide Imaging

The physical findings, clinical signs, age, breed and sex distributions, and laboratory data of 117 dogs with untreated Cushing's syndrome were reviewed. Poodles, Dachshunds, and Boxers of all ages were found to be at increased risk, as were dogs of all breeds greater than or equal to 6 years old. Polydipsia, polyuria, progressive bilaterally symmetric alopecia, and abdominal distention were the most frequently observed clinical signs and physical findings. Lymphopenia, eosinopenia, above normal values of serum alkaline phosphatase, serum cholesterol, and sulfobromphthalein dye retention, and below normal urine specific gravity were the most frequent abnormalities found in the laboratory data. About 50% of the dogs had urinary tract infections. Final diagnosis was established on the basis of abnormally high plasma corticosteroid values in response to an intramuscular injection of adrenocorticotropic hormone.

Topics: 17-Ketosteroids; Adrenal Cortex Hormones; Animals; Blood Glucose; Cushing Syndrome; Dog Diseases; Dogs; Female; Insulin; Male

A cyclic excess of cortisol secretion was detected in a patient with diabetes insipidus and diabetes mellitus. The cycles of hypercortisolism were of 7 days' duration, but during the nadir of these cycles urinary excretion of corticosteroids and 17-ketosteroids was within the normal range. The radiological appearance of the sella turcica was normal; however, computerized axial tomography of the head revealed a small tumor immediately superior to the sella turcica. At operation a small chromophobe adenoma superior to the diaphragma sellae and involving the hypophysial stalk was partially resected. Postoperatively, the patient continued to have 7-day cycles of increased corticosteroid excretion, but the amounts excreted were less than they had been preoperatively. Other patients have been described in whom Cushing's disease has been due to cyclic hypercortisolism. These cycles have been remarkably regular in individual patients, but of variable duration in different patients. Furthermore, cyclic hormonogenesis probably occurs in a variety of endocrinopathies. (Neurosurgery, 5: 598--603, 1979).

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adenoma, Chromophobe; Adrenal Cortex; Adult; Cushing Syndrome; Dexamethasone; Diabetes Insipidus; Humans; Hydrocortisone; Male; Periodicity; Pituitary Neoplasms; Vasopressins

Pituitary function has been studied sequentially after transsphenoidal removal of pituitary microadenomas in two men with Cushing's disease. Patient 1 gradually regained normal glucocorticoid levels with normal diurnal variation, metyrapone responsiveness, and low dose dexamethasone suppressibility (17-hydroxycorticosteroid, 6.5-0.9 mg/24 h). GH levels rose from 1 to 35 ng/ml during insulin hypoglycemia and from 2.3 to 27 ng/ml during arginine infusion. PRL secretion rose normally in response to thorazine, and gonadotropin and TSH levels remained normal. Patient 2 regained significant metyrapone responsiveness by 9 months postoperatively (11-deoxycortisol rose to 11.7 micrograms/dl), had a normal spontaneous nocturnal rise in PRL secretion, and normal levels of testosterone and thyroid hormones. The return to normal of cortisol-ACTH dynamics and GH responsiveness in Patient 1 and the normal nocturnal surge in PRL secretion in Patient 2 imply that in these patients the etiology of Cushing's disease was not related to hypothalamic dysfunction.

Topics: 17-Ketosteroids; Adenoma; Adult; Cushing Syndrome; Follicle Stimulating Hormone; Humans; Hydrocortisone; Insulin; Luteinizing Hormone; Male; Metyrapone; Pituitary Gland; Pituitary Neoplasms; Thyroxine

A 41-yr-old female with presumed Cushing's syndrome was found to have a diurnal cortisol rhythm characterized by low values of 8:00 a.m. and consistently high values at 4:00 p.m. and midnight. Hourly sampling of plasma cortisol over 24 hr confirmed this rhythm, as did measurement of urinary free cortisols in samples collected every 6 hr over 24 hr. Hypercortisolemia was not suppressed by 2 mg of dexamethasone given every 6 hr for 24 hr. The adrenal tissue was responsive to ACTH. Iodocholesterol scanning revealed unilateral activity, and the patient's syndrome was cured by resection of an adrenal adenoma. In this patient a diurnal cortisol secretory pattern was present due to the secretory activity of the adenoma. The cause of the abnormal but persistent diurnal pattern is unknown.

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adenoma; Adrenal Gland Neoplasms; Adrenal Glands; Adrenocorticotropic Hormone; Adult; Circadian Rhythm; Cushing Syndrome; Dexamethasone; Female; Humans; Hydrocortisone

Seven patients with Cushing's syndrome were treated with trilostane (WIN 24,540) 4 alpha,5-epoxy-17 beta-hydroxy-3-oxo-5 alpha-androstane-2 alpha-carbonitrile), an inhibitor of adrenal steroid biosynthesis. Trilostane treatment reduced steroid biosynthesis and it also improved biochemical manifestations of the disease in all of the patients treated. The average cortisol secretory rate decreased significantly with treatment, from 47.1 to 23.4 mg/24 h (P less than 0.005), and urinary 17-hydroxycorticosteroids decreased from 15.7 to 8.7 mg/24 h (P less than 0.01). Urinary free cortisol excretion decreased from 277 to 88 microgram/24 h (P less than 0.01), and 0800 h plasma cortisol levels declined from 25.0 to 12.0 microgram/dl (P less than 0.05). Conversely, dehydroepiandrosterone sulfate excretion in urine increased from 1.3 to 5.8 mg/24 h (P less than 0.0025) and in plasma increased from 162 mg/24 h (P less than 0.025). Plasma and urinary free dehydroepiandrosterone increased 2-fold. Urinary 17-ketosteroid excretion increased from 18 to 43 mg/24 h (P less than 0.001). A significant reduction in urinary excretion of tetrahydroaldosterone, tetrahydrodeoxycorticosterone, and 18-hydroxytetrahydrodeoxycorticosterone was observed with treatment. Inhibition of steroid biosynthesis was accompanied by a 2-fold increase in PRA and no change in serum cholesterol levels. Mean arterial blood pressure decreased with treatment from 109 to 97 mm Hg (P less than 0.005), and fasting blood sugar decreased from 117 to 98 mg/dl (P less than 0.005), accompanied by rise in plasma potassium levels from 3.8 to 4.3 milliequivalents/liter (P less than 0.025). Two patients on long term therapy also showed an improvement in clinical features of their disease. There were no significant treatment-related carcinoma, simultaneously producing both an excessive amount of cortisol and ACTH, is described. It is concluded that trilostane is an effective inhibitor of 3 beta-hydroxysteroid dehydrogenase enzyme system in human adrenal gland; it inhibits biosynthesis of cortisol and it is useful in the treatment of Cushing's syndrome.

Topics: 17-Ketosteroids; Adrenal Cortex Hormones; Adrenal Cortex Neoplasms; Adrenocorticotropic Hormone; Adult; Blood Pressure; Carcinoma; Cushing Syndrome; Dehydroepiandrosterone; Dehydroepiandrosterone Sulfate; Dihydrotestosterone; Female; Humans; Hydrocortisone; Kinetics; Male; Middle Aged; Mineralocorticoids; Potassium; Renin

Topics: 17-Ketosteroids; Adrenal Cortex Diseases; Adrenal Cortex Hormones; Adrenal Gland Diseases; Adrenal Gland Neoplasms; Adrenal Medulla; Adult; Cushing Syndrome; Dexamethasone; Epinephrine; Female; Humans; Middle Aged; Norepinephrine; Pheochromocytoma

A patient with adrenocortical carcinoma had three major endocrine abnormalities attributable directly to the tumor: hypercortisolism (Cushing's syndrome), hyperestrogenism (feminization), and hypercalcemia (pseudohyperparathyroidism). There were higher levels of immunoreactive parathyroid hormone in venous effluent from the tumor or its abdominal metastases compared to that found in the veins draining the parathyroid glands. This, together with the presence of normal parathyroid glands on autopsy, established the diagnosis of pseudohyperparathyroidism as the cause of hypercalcemia in this patient.

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenal Cortex Neoplasms; Adrenal Gland Neoplasms; Adult; Aminoglutethimide; Androstenedione; Cushing Syndrome; Dexamethasone; Estrogens; Feminization; Humans; Hyperparathyroidism; Male; Metyrapone; Mitotane; Paraneoplastic Endocrine Syndromes; Parathyroid Hormone; Testosterone

Topics: 17-Ketosteroids; Adrenal Cortex Hormones; Cushing Syndrome; Humans; Hydrocortisone; Methods; Reagent Kits, Diagnostic

Plasma 11-deoxycorticosterone levels were manyfold elevated in three adult patients with hypertension and elevated urinary excretion levels of 17-ketosteroids but without Cushing's syndrome. Dexamethasone therapy resulted in suppression of these steroids and in improvement of blood pressure in two of the patients. A partial adrenal 11beta-hydroxylase deficiency appears to best explain these findings.

Topics: 17-Ketosteroids; Adrenal Glands; Adult; Age Factors; Blood Pressure; Cushing Syndrome; Desoxycorticosterone; Dexamethasone; Female; Humans; Hypertension; Male; Mixed Function Oxygenases

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenal Cortex Neoplasms; Adrenal Gland Neoplasms; Adrenal Hyperplasia, Congenital; Child; Chromatography, Gas; Cushing Syndrome; Female; Humans; Male

Topics: 17-Ketosteroids; Adrenalectomy; Adrenocorticotropic Hormone; Cushing Syndrome; Dexamethasone; Follow-Up Studies; Humans; Hydrocortisone; Pituitary Irradiation

Extraocular muscle pareses in patients with Cushing syndrome are virtually always associated with a greatly enlarged pituitary tumor and with advancement on oculomotor nerves. The present report concerns a patient with a rapidly progressive adrenocorticotropic hormone (ACTH)-dependent hyperadrenocorticism and sudden onset of an unilateral third nerve paresis. The patient had no demonstrable pituitary tumor. After a total adrenalectomy and correction of hyperadrenocortisolism, his third nerve paresis subsided. Ocular paresis may occur in a patient with Cushing syndrome even in the absence of mechanical involvement of ocular nerves by a pituitary tumor.

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenalectomy; Cushing Syndrome; Dexamethasone; Humans; Male; Middle Aged; Ophthalmoplegia

1. Results of tests for the diagnosis of Cushings syndrome of varoius aetiologies are discussed for twenty-five patients in whom the pathology was established by operation or autopsy. 2. Control values for the urinary excretion of free cortisol, 17-OHCS, Porter-Silber chromogens (P-SC) and 17-OS and plasma levels of P-SC are compared with those for normal subjects. 3. The results indicated that urinary values are within the normal range for some patients with Cushing's syndrome. 4. Plasma levels of P-SC in the morning were within the normal range for the majority and elevated for the rest. 5. Some patients showed day-night variation of plasma P-SC but evening values were above the normal range. 6. The expected response for low dosage dexamethasone was found in all patients tested but unexpected responses followed high dosage in some. 7. Plasma 11-OHCS in the five patients tested failed to respond to insulin induced hypoglycaemia. 8. Metyrapone administration and corticotrophin infusion tests had limited usefulness in establishing the aetiology of the disease. The 17-OHCS excretion became raised in the response to corticotrophin and the evaluation was prolonged beyond normal responsiveness.

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adolescent; Adrenal Cortex Diseases; Adrenal Cortex Function Tests; Adult; Aged; Cushing Syndrome; Diagnosis, Differential; Evaluation Studies as Topic; Female; Humans; Hydrocortisone; Male; Middle Aged

Aseptic necrosis of bone is a known complication of corticosteroid therapy. We report a case of aseptic necrosis of the femoral head as a presenting symptom of Cushing's disease. The case demonstrates that endogenous steroids, like exogenous steroids, may bear the same relationship to the pathogenesis of aseptic necrosis of bone. It also indicates that Cushing's disease must be considered in every case of so-called idiopathic aseptic necrosis of bone.

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Cushing Syndrome; Femur Head Necrosis; Humans; Hydrocortisone; Male; Middle Aged

A patient with Cushing's disease due to a chromophobe adenoma was studied for 243 days before pituitary surgery and evidence for periodicity in cortisol steroid production was found with cycles occurring every 85.8 days (peak-to-peak length), associated with laboratory remissions and paradoxical response to dexamethasone. The autonomy of ACTH secretion was suggested by the nonresponsiveness to repeated lysine-vasopressin stimulation tests and lack of increase in urinary 170HCS following metyrapone. A distinct response of the hyperplastic glands (as demonstrated by percutaneous adrenal venography) was obtained on several B1-24 corticotropin stimulation. The patient's hypercortisolism disappeared following removal of the chromophobe adenoma through transphenoidal hypophysectomy.

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenocorticotropic Hormone; Adult; Cosyntropin; Cushing Syndrome; Dexamethasone; Humans; Hydrocortisone; Hypophysectomy; Lypressin; Male; Metyrapone; Periodicity; Remission, Spontaneous

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Age Factors; Child, Preschool; Cushing Syndrome; Humans; Male

1. Using a newly developed and validated radioassay method, we have measured plasma 11-deoxycorticosterone concentrations in a wide spectrum of human hypertensive states. 2. Patients with essential and renovascular hypertension have normal plasma concentrations of 11-deoxycorticosterone. 3. Elevated concentrations are seen in some patients with primary aldosteronism, Cushing's syndrome, low-renin hypertension, and in adult hypertensive subjects with elevated urinary 17-ketosteroid excretion. 4. An aetiological role for deoxycorticosterone in certain forms of human hypertension appears likely.

Topics: 17-Ketosteroids; Cushing Syndrome; Desoxycorticosterone; Humans; Hyperaldosteronism; Hypertension

Thirty-four cases of corticosurrenaloma with clinical onset before 15 years of age have been studied. Higher frequency in girls (65 percent of the cases) and in young age (80 percent before 5 years of age, 43 percent before 2 years), association with personal or familial other tumors and malformations, are noticeable features. Virilism is the major manifestation in children (83 percent of the cases), either isolated or associated with hypercortisolism and/or feminization. Hormonal assays are of little value, and the dynamic adrenal tests are of some help only in small tumors or isolated hypercortisolism. Radiological diagnosis by urography with cavography, arteriography, is easy in most cases. Evaluation of prognosis is very difficult. Clinical and biological data are not significant, histological data are often of little help. Only a very large mass, and occurrence of metastases (liver, lungs) evidence malignancy. This series does not allow to assess definitely the best therapeutic regimen. Surgery has to be performed as soon as possible. The effects of radiations have not yet been ascertained. High doses of op'DDD have led to a sustained remission of the tumor or metastases in 2 patients, and perhaps to a longer survival in 4 others.

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adenoma; Adolescent; Adrenal Cortex Neoplasms; Adrenal Gland Neoplasms; Adrenocortical Hyperfunction; Angiography; Child; Child, Preschool; Cushing Syndrome; Dehydroepiandrosterone; Female; Feminization; Humans; Male; Mitotane; Urography; Virilism

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adolescent; Adrenocorticotropic Hormone; Body Height; Cushing Syndrome; Dexamethasone; Diagnosis, Differential; Glucose Tolerance Test; Growth Disorders; Humans; Hydrocortisone; Male; Pyrones; Stimulation, Chemical

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenal Gland Neoplasms; Adrenal Glands; Adrenocorticotropic Hormone; Adult; Carcinoma; Cushing Syndrome; Dexamethasone; Female; Humans; Metyrapone; Phlebography; Retropneumoperitoneum

The following examinations, including the estimation of urinary neutral steroid metabolites, plasma cortisol, the percentage of unbound-cortisol, cortisol production rate, plasma adrenocorticotrophin (ACTH), dexamethasone suppression test, ACTH stimulation test, metopirone test, lysine-vasopressin (LVP) test and insulin tolerance test, were conducted in 16 patients with Cushing's syndrome for the presence of hypercoticism and for identifying the cause of this syndrome. Of these tests, the measurements of plasma cortisol late in the day and single dose dexamethasone suppression test were most useful for the diagnosis of hypercorticism because of their reliability and simplicity. Urinary 17-KGS, THF/THE ratio, cortisol production rate and low dose dexamethasone suppression test were also useful, whereas insulin test and LVP test were less valuable for this purpose. For the identification of the causes of this syndrome, lysine vasopressin test and metopirone test were most reliable, and plasma ACTH was also useful for this purpose, whereas insulin test and ACTH stimulation test were less valuable.

Topics: 17-Ketosteroids; Adolescent; Adrenal Cortex Function Tests; Adrenal Gland Neoplasms; Adrenocorticotropic Hormone; Adult; Androsterone; Child, Preschool; Cosyntropin; Cushing Syndrome; Dexamethasone; Diagnosis, Differential; Etiocholanolone; Female; Humans; Hydrocortisone; Hypothalamus; Insulin; Lypressin; Male; Metyrapone; Middle Aged; Pituitary Function Tests; Pituitary-Adrenal Function Tests; Tetrahydrocortisol; Tetrahydrocortisone

In two patients who were severely pigmented (Nelson syndrome) following bilateral adrenalectomy for Cushing syndrome, symptoms of hyper-cortisolism developed while they were receiving only physiologic steroid replacement. Cortical assays proved that endogenous cortisol production had not been obliterated. Even after total adrenalectomy, steroid measurement should be performed to guard against adrenocortical excess.

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenal Cortex Function Tests; Adrenalectomy; Adrenocorticotropic Hormone; Adult; Cushing Syndrome; Female; Humans; Hydrocortisone; Pigmentation Disorders; Recurrence; Syndrome

The effect of intravenous synthetic luteinizing hormone releasing hormone (LH-RH) on plasma radioimmunoassayable levels of gonadotropins was investigated in 6 women suffering from Cushing's disease with bilateral adrenal hyperplasia. In five of six cases no significant variation of plasma LH levels was found following stimulation; in one case the response to LH-RH was present although slightly reduced below the normal range. By contrast in all cases the plasma FSH response was similar to that recorded in normal subjects. The explanation of impaired LH response is not clear but the possibility that endogenous hypercortisolism affects the pituitary responsiveness to LH-RH has to be considered.

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adult; Aged; Amenorrhea; Cushing Syndrome; Estradiol; Female; Follicle Stimulating Hormone; Gonadotropin-Releasing Hormone; Humans; Hydrocortisone; Luteinizing Hormone; Middle Aged; Pituitary Gland; Progesterone; Testosterone; Time Factors

Steroid production, plasma renin activity (PRA) and plasma renin substrate (PRS) were measured in eight patients with hypertension due to Cushing's syndrome of benign origin. Despite elevation of cortisol secretion in all patients, hypokalemia and suppressed PRA was noted in the one subject with a functioning adrenal adenoma. PRA was normal in six patients on an unrestricted sodium intake but was markedly increased in the two patients on low salt diets. PRS was significantly increased during active disease, but decreased substantially with treatment. The absence of uniform hypokalemia and of suppression of renin indicates that mineralocorticoid production could not account for the increase in arterial pressure. It is suggested that glucocorticoid-induced hypertension may be initiated by alterations in vascular responsiveness to pressor agents and that elevated PRS levels may contribute to increase angiotensin formation.

Topics: 17-Ketosteroids; Adult; Angiotensin II; Cushing Syndrome; Diet; Female; Humans; Hydrocortisone; Hydroxysteroids; Hypertension; Male; Middle Aged; Potassium; Renin; Sodium Chloride

Topics: 17-Ketosteroids; Adolescent; Adult; Aged; Chromatography, Gas; Cushing Syndrome; Female; Humans; Male; Middle Aged; Virilism

On account of the increasing number of patients with essential obesity the delimitation of the Cushing-syndrome is of actual importance. Two observations of hypercortisolism in hyperplasia of the adrenal glands are reported on and the differential-diagnostically important parameters are demonstrated. According to our opinion anamnesis and clinical findings give the possibility of making a diagnosis already on a large scale. Analyses of the hormones and special X-ray examinations only serve for the preoperative ascertainment and localisation of the endocrine defective function. With the help of literary data causes and possibilities of treatment of Cushing's syndrome are entered.

Topics: 17-Ketosteroids; Adenoma; Adolescent; Adrenal Gland Neoplasms; Adrenocortical Hyperfunction; Adult; Cushing Syndrome; Diagnosis, Differential; Diet, Reducing; Female; Humans; Hydrocortisone; Male; Obesity

Topics: 11-Hydroxycorticosteroids; 17-Hydroxycorticosteroids; 17-Ketosteroids; Adenoma; Adolescent; Adrenal Gland Diseases; Adrenal Gland Neoplasms; Adult; Androstenedione; Androsterone; Carcinoma; Chromatography, Ion Exchange; Cushing Syndrome; Dehydroepiandrosterone; Etiocholanolone; Female; Humans; Hyperplasia; Male; Middle Aged; Sex Factors; Tetrahydrocortisol

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenocorticotropic Hormone; Adult; Aldosterone; Cushing Syndrome; Female; Follow-Up Studies; Humans; Hydrocortisone; Mitotane; Remission, Spontaneous

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adenoma; Adrenal Gland Neoplasms; Adrenalectomy; Adrenocorticotropic Hormone; Adult; Blood Pressure; Cortisone; Cushing Syndrome; Dexamethasone; Female; Humans; Hyperaldosteronism; Pigmentation Disorders

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenal Gland Diseases; Adrenal Glands; Adrenocorticotropic Hormone; Adult; Age Determination by Skeleton; Angiography; Back Pain; Bone Diseases; Cortisone; Cushing Syndrome; Dexamethasone; Female; Fludrocortisone; Humans; Hydrocortisone; Male; Radioimmunoassay; Rib Fractures

Topics: 17-Ketosteroids; Addison Disease; Adrenal Cortex; Adrenal Gland Diseases; Adrenal Glands; Adrenocorticotropic Hormone; Adult; Circadian Rhythm; Cushing Syndrome; Dexamethasone; Female; Humans; Hydrocortisone; Hydroxyprogesterones; Hyperplasia; Insulin; Male; Metyrapone; Middle Aged; Radiography; Skull; Sodium; Steroid Hydroxylases; Time Factors

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenal Glands; Adult; Aldosterone; Cushing Syndrome; Estradiol; Estrone; Female; Humans; Hyperaldosteronism; Male; Middle Aged; Phlebography; Radioimmunoassay; Renin; Tritium

Topics: 17-Ketosteroids; Adolescent; Adrenal Gland Neoplasms; Adrenal Hyperplasia, Congenital; Adult; Cholesterol; Cushing Syndrome; Female; Humans; Hypercholesterolemia; Middle Aged

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenocortical Hyperfunction; Cushing Syndrome; Drug Therapy, Combination; Humans; Neomycin; Sulfanilamides

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adult; Circadian Rhythm; Corticotropin-Releasing Hormone; Cushing Syndrome; Dexamethasone; Dihydroxyphenylalanine; Drug Evaluation; Female; Humans; Hydrocortisone; Hypothalamo-Hypophyseal System; Methyldopa; Stimulation, Chemical; Vasopressins

Topics: 17-Ketosteroids; Adolescent; Adrenal Cortex Hormones; Adrenal Gland Diseases; Body Height; Body Weight; Cortisone; Cushing Syndrome; Female; Fludrocortisone; Humans; Hydrocortisone; Hyperplasia; Metyrapone; Mitotane

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenocortical Hyperfunction; Adrenocorticotropic Hormone; Aminoglutethimide; Cushing Syndrome; Female; Hormones, Ectopic; Humans; Hydrocortisone; Melanoma; Metyrapone; Middle Aged; Mitotane; Neoplasm Metastasis; Palliative Care

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenal Hyperplasia, Congenital; Adrenocorticotropic Hormone; Adult; Cushing Syndrome; Dexamethasone; Female; Humans; Pregnancy; Pregnancy Complications

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Administration, Oral; Adrenocorticotropic Hormone; Adult; Circadian Rhythm; Cushing Syndrome; Dexamethasone; Dihydroxyphenylalanine; Female; Glucose Tolerance Test; Growth Hormone; Humans; Hydrocortisone; Insulin; Male; Middle Aged; Phenylacetates; Secretory Rate

Topics: 17-Ketosteroids; Adrenal Hyperplasia, Congenital; Adrenal Insufficiency; Adrenocorticotropic Hormone; Body Weight; Bone Development; Child; Child, Preschool; Cushing Syndrome; Desoxycorticosterone; Diagnosis, Differential; Diagnostic Errors; Fludrocortisone; Glucocorticoids; Growth Disorders; Growth Hormone; Humans; Hydrocortisone; Infant; Infant, Newborn; Insulin; Male; Methylprednisolone; Metyrapone; Mineralocorticoids; Pituitary-Adrenal Function Tests

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Administration, Topical; Anti-Inflammatory Agents; Cushing Syndrome; Dimethyl Sulfoxide; Drug Tolerance; Humans; Hydrocortisone; Pharmaceutic Aids; Pigmentation Disorders; Skin Absorption; Telangiectasis

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adenocarcinoma; Adenoma; Adolescent; Adrenal Gland Neoplasms; Adult; Amenorrhea; Child, Preschool; Cushing Syndrome; Female; Hirsutism; Humans; Infertility, Female; Polycystic Ovary Syndrome; Virilism

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenal Glands; Adult; Blood Proteins; Child; Creatinine; Cushing Syndrome; Depression, Chemical; Dexamethasone; Female; Humans; Hydrocortisone; Kidney; Male; Metyrapone; Middle Aged; Pituitary Diseases; Protein Binding

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenal Gland Neoplasms; Adult; Aged; Aldosterone; Child; Child, Preschool; Cushing Syndrome; Female; Humans; Hyperaldosteronism; Hypertension; Hypertension, Malignant; Hypertension, Renal; Male; Middle Aged; Pheochromocytoma; Potassium; Renin; Sodium; Sweat

Topics: 17-Ketosteroids; Adrenal Gland Diseases; Adrenal Gland Neoplasms; Chromatography, Gas; Chromatography, Thin Layer; Cushing Syndrome; Female; Hirsutism; Humans; Infertility, Female; Male; Pregnanetriol

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Aminoglutethimide; Cushing Syndrome; Dose-Response Relationship, Drug; Glucuronidase; Humans; Hydrocortisone; Time Factors

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adult; Cushing Syndrome; Dexamethasone; Female; Humans; Hydrocortisone; Male; Middle Aged; Obesity; Prospective Studies

Topics: 17-Ketosteroids; Acromegaly; Anesthesia, General; Cerebrospinal Fluid Rhinorrhea; Corticosterone; Cushing Syndrome; Diabetic Retinopathy; Humans; Hydrocortisone; Intubation, Intratracheal; Nasopharynx; Pituitary Gland; Pituitary Irradiation; Pneumoencephalography; Postoperative Care; Postoperative Complications; Preoperative Care; Radioisotopes; Water-Electrolyte Balance; Yttrium Isotopes

Topics: 17-Ketosteroids; Adolescent; Adult; Child; Chronic Disease; Cushing Syndrome; Estrogens; Female; Humans

Topics: 17-Ketosteroids; Adolescent; Adult; Asthma; Bronchial Neoplasms; Cushing Syndrome; Female; Glucocorticoids; Humans; Hydroxycorticosteroids; Male; Middle Aged; Nephritis; Rheumatic Fever; Sarcoidosis; Thyroid Function Tests; Thyroid Gland; Thyrotropin; Thyrotropin-Releasing Hormone; Triiodothyronine

Topics: 17-Ketosteroids; Adult; Arginine; Corticosterone; Cushing Syndrome; Diagnosis, Differential; Female; Growth Hormone; Humans; Hypothyroidism; Iodine Radioisotopes; Lactation Disorders; Luteinizing Hormone; Middle Aged; Pituitary Neoplasms; Pregnancy; Stimulation, Chemical; Thyroid Function Tests; Thyroid Gland; Triiodothyronine

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Addison Disease; Adult; Androgens; Androsterone; Chromatography, Gas; Cushing Syndrome; Dehydroepiandrosterone; Etiocholanolone; Female; Hirsutism; Humans; Hydrocortisone; Hypogonadism; Hypopituitarism; Male; Pregnancy; Pregnanediol; Pregnanetriol

Topics: 17-Ketosteroids; Acne Vulgaris; Adrenal Glands; Adult; Blood Cell Count; Cushing Syndrome; Diabetes Complications; Diagnosis, Differential; Ecchymosis; Female; Hirsutism; Humans; Hydrocortisone; Hypertension; Ketosteroids; Male; Obesity

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenal Glands; Adrenalectomy; Adrenocorticotropic Hormone; Adult; Aldosterone; Cushing Syndrome; Dexamethasone; Female; Humans; Hydrocortisone; Male; Metyrapone; Middle Aged; Recurrence

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adolescent; Adrenalectomy; Adrenocorticotropic Hormone; Basal Metabolism; Child; Cushing Syndrome; Female; Fludrocortisone; Growth Disorders; Growth Hormone; Humans; Hydrocortisone; Thyroxine

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenal Gland Diseases; Adrenal Insufficiency; Adrenocorticotropic Hormone; Aldosterone; Clinical Laboratory Techniques; Cushing Syndrome; Electrolytes; Humans; Hydrocortisone; Hypopituitarism; Pituitary-Adrenal Function Tests; Testosterone

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Acromegaly; Adrenal Gland Diseases; Bone Diseases; Cushing Syndrome; Dwarfism, Pituitary; Endocrine System Diseases; Female; Gigantism; Growth Hormone; Humans; Male; Ossification, Heterotopic; Pituitary Diseases; Radiography; Thyroid Diseases; Thyroid Hormones

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenal Glands; Adrenalectomy; Adult; Circadian Rhythm; Cushing Syndrome; Dexamethasone; Dichlorodiphenyldichloroethane; Female; Humans; Hydrocortisone; Hyperplasia; Metyrapone; Middle Aged; Pituitary-Adrenal Function Tests; Radiography; Secretory Rate; Sella Turcica

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adult; Carcinoma; Cushing Syndrome; Humans; Male; Thyroid Neoplasms; Thyroidectomy

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adenoma; Adolescent; Adrenal Cortex Hormones; Adrenal Gland Diseases; Adrenal Gland Neoplasms; Adrenalectomy; Adrenocortical Hyperfunction; Adult; Cushing Syndrome; Dexamethasone; Female; Glucocorticoids; Humans; Hyperplasia; Middle Aged; Pituitary Irradiation; Postoperative Care; Postoperative Complications; Radiography

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adenoma; Adrenal Gland Neoplasms; Carbon Isotopes; Culture Techniques; Cushing Syndrome; Humans; Infant; Testosterone; Tritium

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Androstanes; Carbon Isotopes; Chromatography, Gas; Chromatography, Ion Exchange; Cushing Syndrome; Electrophoresis, Paper; Etiocholanolone; Female; Glucocorticoids; Glucuronates; Humans; Hydrocortisone; Ketosteroids; Methods; Pregnanes; Sulfuric Acids

Topics: 17-Ketosteroids; Adrenal Glands; Androstanes; Breast Neoplasms; Carbon Isotopes; Chromatography, Paper; Chromatography, Thin Layer; Cushing Syndrome; Humans; Hydrocortisone; In Vitro Techniques; Progesterone; Tritium

Topics: 17-Ketosteroids; Adolescent; Adrenal Hyperplasia, Congenital; Adult; Colorimetry; Cushing Syndrome; Disorders of Sex Development; Evaluation Studies as Topic; Female; Humans; Male; Mathematics; Methods; Photochemistry; Polycystic Ovary Syndrome; Thyroidectomy

Topics: 17-Ketosteroids; Adrenal Gland Neoplasms; Androgens; Cushing Syndrome; Estrogens; Female; Hirsutism; Humans; Hydrocortisone; Infertility, Female; Ovarian Cysts; Ovarian Neoplasms; Testosterone

Topics: 17-Ketosteroids; Adolescent; Adrenal Cortex Hormones; Adrenalectomy; Body Height; Body Weight; Child; Child, Preschool; Cushing Syndrome; Dexamethasone; Dwarfism; Female; Growth Hormone; Humans; Hydrocortisone; Ketosteroids; Male; Obesity; Postoperative Complications; Steroids

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adenocarcinoma; Adenoma; Adolescent; Adrenal Gland Neoplasms; Adrenalectomy; Affective Symptoms; Age Factors; Aged; Cushing Syndrome; Depression; Female; Humans; Mental Disorders; Middle Aged; Potassium

A patient with Cushing's syndrome whose clinical manifestations began at approximately 9 years of age was followed for a period of four years. Initial laboratory studies revealed urinary 170HCS and 17 KS levels which were elevated for her age, with a normal diurnal variation of plasma cortisol and normal suppression of urinary 170HCS by 1.5 mg. of dexamethasone daily. It was not until four years after the onset of the disease that laboratory studies unequivocally supported the diagnosis of Cushing's syndrome resulting in definitive therapy. Clinical features consisted primarily of cessation of growth, obesity, and hirsutism, with no evidence of protein depletion. It is suggested that the clinical and laboratory features of Cushing's syndrome in childhood may present differences from those found in the adult. Failure to recognize these differences may result in delay in therapy with subsequent persisting stigmata of the disorder.

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adolescent; Adrenalectomy; Child; Circadian Rhythm; Cortisone; Cushing Syndrome; Dexamethasone; Female; Humans; Hydrocortisone; Recurrence

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adult; Circadian Rhythm; Cushing Syndrome; Female; Gestational Age; Humans; Hydrocortisone; Infant, Newborn; Pregnancy; Pregnancy Complications; Remission, Spontaneous

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenocortical Hyperfunction; Cushing Syndrome; Diagnosis, Differential; Female; Humans; Hydrocortisone; Middle Aged; Obesity

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adenoma; Adolescent; Adrenal Gland Neoplasms; Adrenal Insufficiency; Adrenalectomy; Adrenocortical Hyperfunction; Adult; Alkaline Phosphatase; Cushing Syndrome; Female; Humans; Hyperostosis Frontalis Interna; Hypothalamic Diseases; Hypothyroidism; Leukocytes; Male; Middle Aged; Neutrophils; Obesity; Osteoporosis

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Addison Disease; Adolescent; Adult; Arteriosclerosis; Ballistocardiography; Blood Glucose; Capillary Permeability; Cardiovascular System; Cholesterol; Cushing Syndrome; Female; Glycosaminoglycans; Humans; Lipids; Lipoproteins; Male; Methods; Middle Aged; Neuraminic Acids; Potassium; Pulse; Saliva; Sodium

Topics: 17-Ketosteroids; Adenoma; Adolescent; Adrenal Gland Neoplasms; Adrenal Hyperplasia, Congenital; Adrenal Insufficiency; Adult; Aged; Alcohols; Amenorrhea; Androsterone; Carcinoma; Child, Preschool; Chromatography, Gas; Cushing Syndrome; Dehydroepiandrosterone; Etiocholanolone; Female; Genital Diseases, Male; Hirsutism; Humans; Hyperplasia; Hyperthyroidism; Hypospadias; Infant; Infertility, Male; Klinefelter Syndrome; Lactation Disorders; Male; Middle Aged; Polycystic Ovary Syndrome; Pregnancy; Pregnanetriol

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenal Rest Tumor; Adrenocorticotropic Hormone; Androstanes; Autopsy; Chromatography; Corticosterone; Cushing Syndrome; Dehydroepiandrosterone; Dexamethasone; Edema; Humans; Hydrocortisone; Hypokalemia; Male; Metyrapone; Middle Aged; Mixed Function Oxygenases; Neoplasm Metastasis; Pregnanes; Pregnenolone; Progesterone; Retroperitoneal Neoplasms; Scrotum; Tritium

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adenoma; Adolescent; Adrenal Gland Neoplasms; Adrenocorticotropic Hormone; Adult; Aged; Child; Child, Preschool; Cushing Syndrome; Dexamethasone; Female; Humans; Hydrocortisone; Infant; Male; Middle Aged; Pituitary-Adrenal Function Tests; Radiography

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenalectomy; Adrenocorticotropic Hormone; Adult; Bronchial Neoplasms; Carcinoma, Adenoid Cystic; Cortisone; Cushing Syndrome; Dexamethasone; Humans; Male; Metyrapone

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenocorticotropic Hormone; Adult; Aged; Aldosterone; Alkalosis; Carcinoma, Bronchogenic; Corticosterone; Cushing Syndrome; Deficiency Diseases; Desoxycorticosterone; Humans; Hypokalemia; Lung Neoplasms; Male; Middle Aged; Pancreatic Neoplasms

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adolescent; Adrenal Cortex Hormones; Adrenal Glands; Adrenocorticotropic Hormone; Adult; Cushing Syndrome; Female; Humans; Male; Obesity; Puberty; Stimulation, Chemical

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenal Cortex Hormones; Adrenal Glands; Cushing Syndrome; Humans; Male; Middle Aged; Pituitary Gland; Pituitary-Adrenal Function Tests; Radiography

Topics: 17-Ketosteroids; Adolescent; Adrenal Gland Neoplasms; Adrenal Hyperplasia, Congenital; Adult; Aged; Child; Child, Preschool; Chromatography, Gas; Chromatography, Thin Layer; Cushing Syndrome; Female; Humans; Liver Diseases; Male; Methods; Middle Aged; Thyroid Diseases; Turner Syndrome

Topics: 17-Ketosteroids; Adult; Age Factors; Aged; Androstanes; Androsterone; Cholanes; Chromatography, Gas; Cushing Syndrome; Female; Humans; Hydrocortisone; Hypothyroidism; Male; Middle Aged; Obesity; Pregnanediol; Pregnanes; Secretory Rate

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adult; Creatinine; Cushing Syndrome; Female; Humans; Hydrocortisone; Menorrhagia; Pituitary Irradiation; Pregnancy; Pregnancy Complications

A case of a rare association between pregnancy and the development of Cushing's syndrome is discussed. A 29-year-old woman developed Cushing's syndrome, characterized by hypokalemia, a high level of urinary 17-hydroxycorticoids not suppressed by dexamethasone therapy, a high level of plasma 11-hydroxycorticoids which did not show diurnal variation and failed to show suppression after dexamethasone therapy, and a high level of urinary 17-ketosteroids, within 12 weeks of her first pregnancy. Clinical and biochemical abnormalities disappeared rapidly after dilatation and curettage. No evidence of an ectopic ACTH-producing tumor or an adrenal cortical tumor was found. Abnormalities did not reappear with administration of HCG or with sequential estrogen-progestogen treatment.

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Abortion, Therapeutic; Adrenal Gland Neoplasms; Adult; Chorionic Gonadotropin; Cushing Syndrome; Dexamethasone; Estrogens; Female; Humans; Hypokalemia; Potassium; Pregnancy; Pregnancy Complications

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenal Cortex Hormones; Adrenal Gland Neoplasms; Adrenal Hyperplasia, Congenital; Androsterone; Chromatography, Gas; Cushing Syndrome; Etiocholanolone; Humans; Hydrocortisone; Hyperthyroidism; Male; Pregnanetriol

Topics: 17-Ketosteroids; Adrenal Cortex Hormones; Adult; Carbohydrate Metabolism; Cushing Syndrome; Female; Glucocorticoids; Humans; Hypertension; Male; Middle Aged; Osteoporosis

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenal Glands; Aminoglutethimide; Aniline Compounds; Anticonvulsants; Circadian Rhythm; Cushing Syndrome; Depression, Chemical; Female; Humans; Middle Aged; Mixed Function Oxygenases; Pregnanediol; Pregnanes; Pregnanetriol; Pyridones

Topics: 17-Ketosteroids; Cushing Syndrome; Female; Hirsutism; Humans; Hyperplasia; Ovarian Cysts; Ovarian Neoplasms; Ovary; Ovulation; Testosterone; Virilism

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Addison Disease; Adult; Arteriosclerosis; Arthritis, Rheumatoid; Cholelithiasis; Cholesterol; Coronary Disease; Cushing Syndrome; Epinephrine; Fibrinolysis; Heparin; Humans; Lipoproteins; Liver Cirrhosis; Middle Aged; Neuraminic Acids; Norepinephrine; Pulse

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenal Gland Neoplasms; Adrenal Glands; Adrenocorticotropic Hormone; Cushing Syndrome; Female; Humans; Middle Aged; Paraganglioma

Topics: 17-Ketosteroids; Acid Phosphatase; Adenocarcinoma; Adrenocorticotropic Hormone; Cushing Syndrome; Cytoplasmic Granules; Glucocorticoids; Histocytochemistry; Hormones, Ectopic; Humans; Hydrocortisone; Lung Neoplasms; Male; Metyrapone; Middle Aged; Oxidoreductases; Pituitary-Adrenal Function Tests; Pyrophosphatases

Topics: 17-Ketosteroids; Adrenal Gland Diseases; Adrenal Hyperplasia, Congenital; Adrenocorticotropic Hormone; Androgens; Chromatography, Gas; Collagen Diseases; Cushing Syndrome; Dehydroepiandrosterone; Dexamethasone; Etiocholanolone; Female; Glucuronidase; Humans; Hyperthyroidism; Hypogonadism; Liver Cirrhosis; Male; Metyrapone; Pregnanes; Sterols

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adolescent; Adrenocorticotropic Hormone; Aldosterone; Child; Cushing Syndrome; Dexamethasone; Female; Humans; Hydrocortisone; Male; Pituitary-Adrenal Function Tests; Secretory Rate; Tritium

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenocorticotropic Hormone; Calcitonin; Carcinoma; Creatinine; Cushing Syndrome; Dexamethasone; Female; Hormones, Ectopic; Humans; Hydrocortisone; Middle Aged; Parathyroid Hormone; Radioimmunoassay; Thyroid Neoplasms

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adenoma; Adrenal Gland Neoplasms; Adrenal Hyperplasia, Congenital; Cushing Syndrome; Dexamethasone; Diagnosis, Differential; Female; Gonadotropins, Pituitary; Humans; Menstruation Disturbances; Norethynodrel; Ovarian Neoplasms; Ovary; Pituitary-Adrenal Function Tests; Polycystic Ovary Syndrome

Topics: 17-Ketosteroids; Adrenalectomy; Adrenocorticotropic Hormone; Age Factors; Animals; Cushing Syndrome; Dog Diseases; Dogs; Female; Male; Sex Factors

Topics: 17-Ketosteroids; Adenoma; Adolescent; Adrenal Gland Neoplasms; Adrenalectomy; Adrenocorticotropic Hormone; Adult; Cushing Syndrome; Dexamethasone; Female; Glucocorticoids; Humans; Male; Middle Aged; Pituitary Neoplasms

Topics: 17-Ketosteroids; Addison Disease; Adrenal Cortex Hormones; Adrenal Gland Diseases; Adrenal Glands; Adrenal Insufficiency; Adrenocorticotropic Hormone; Anorexia Nervosa; Cushing Syndrome; Diagnosis, Differential; Female; Fluorometry; Hirsutism; Humans; Hypopituitarism; Injections, Intravenous; Klinefelter Syndrome; Male; Methods; Obesity; Pituitary Neoplasms; Spectrophotometry; Turner Syndrome

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenal Cortex Hormones; Adrenal Glands; Adrenal Insufficiency; Adrenocorticotropic Hormone; Cushing Syndrome; Humans; Hypothalamo-Hypophyseal System; Pituitary-Adrenal Function Tests; Prednisone; Stress, Physiological; Vasopressins

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adenoma; Adrenal Gland Neoplasms; Cushing Syndrome; Female; Humans; Infant; Male; Obesity; Postoperative Care; Preoperative Care; Urography

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adolescent; Adult; Carbon Isotopes; Circadian Rhythm; Cushing Syndrome; Diagnosis, Differential; Fasting; Female; Humans; Hydrocortisone; Hypothalamo-Hypophyseal System; Male; Middle Aged; Obesity; Pituitary-Adrenal System; Secretory Rate; Steroids; Vasopressins

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adolescent; Adrenal Gland Diseases; Adrenal Gland Neoplasms; Adrenalectomy; Adult; Carcinoma; Cushing Syndrome; Diagnosis, Differential; Humans; Hyperplasia; Precancerous Conditions

Topics: 17-Ketosteroids; Adult; Androsterone; Chemistry, Clinical; Chiari-Frommel Syndrome; Cushing Syndrome; Dehydroepiandrosterone; Dexamethasone; Etiocholanolone; Female; Humans; Hydrocortisone; Pregnancy; Secretory Rate; Tritium

Topics: 17-Ketosteroids; Addison Disease; Adrenal Cortex Hormones; Adrenal Gland Neoplasms; Adrenal Glands; Adrenal Hyperplasia, Congenital; Adrenal Insufficiency; Adrenocortical Hyperfunction; Cholesterol; Cushing Syndrome; Deficiency Diseases; Dehydroepiandrosterone; Female; Menstruation Disturbances; Mixed Function Oxygenases; Virilism

Topics: 17-Ketosteroids; Adolescent; Adrenal Hyperplasia, Congenital; Adrenocortical Hyperfunction; Adult; Chemistry, Clinical; Chromatography, Gas; Cushing Syndrome; Dehydroepiandrosterone; Diagnosis, Differential; Female; Glucocorticoids; Hirsutism; Humans; Pregnanediol; Pregnanetriol

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenocorticotropic Hormone; Aged; Bronchial Neoplasms; Carcinoid Tumor; Cushing Syndrome; Dexamethasone; Female; Glucocorticoids; Hormones, Ectopic; Humans; Metyrapone; Oxacillin; Radiography, Thoracic

Topics: 17-Ketosteroids; Adrenocortical Hyperfunction; Adrenocorticotropic Hormone; Androgens; Carcinoma, Bronchogenic; Chromatography, Gas; Chromatography, Thin Layer; Cushing Syndrome; Female; Humans; Lung Neoplasms; Male; Middle Aged; Neoplasm Metastasis

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenal Gland Neoplasms; Adrenal Hyperplasia, Congenital; Adsorption; Adult; Chemistry, Clinical; Child; Child, Preschool; Cushing Syndrome; Disorders of Sex Development; Ethisterone; Female; Glucuronidase; Hirsutism; Humans; Infant; Magnesium; Methods; Pituitary-Adrenal Function Tests; Polycystic Ovary Syndrome; Pregnanetriol; Puberty, Precocious; Silicon Dioxide; Tetrazolium Salts

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adenoma, Basophil; Adrenalectomy; Adrenocortical Hyperfunction; Adrenocorticotropic Hormone; Adult; Chromatography, Paper; Cushing Syndrome; Dexamethasone; Female; Heart Arrest; Humans; Metyrapone; Pituitary Neoplasms; Pituitary-Adrenal Function Tests; Postoperative Complications

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenocortical Hyperfunction; Adrenocorticotropic Hormone; Adult; Cushing Syndrome; Female; Humans; Hydrocortisone; Middle Aged

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenocortical Hyperfunction; Adrenocorticotropic Hormone; Aminoglutethimide; Bronchial Neoplasms; Cushing Syndrome; Glucocorticoids; Humans; Hyperpituitarism; Lung Neoplasms; Metyrapone

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adolescent; Adrenocorticotropic Hormone; Adult; Child; Cushing Syndrome; Female; Glucocorticoids; Humans; Male; Middle Aged

Topics: 17-Ketosteroids; Adrenal Cortex Hormones; Adrenal Gland Diseases; Adrenal Gland Neoplasms; Adrenalectomy; Adrenocorticotropic Hormone; Age Factors; Child; Cushing Syndrome; Humans; Hyperplasia; Male; Pituitary-Adrenal Function Tests

Topics: 17-Ketosteroids; Adrenal Cortex Hormones; Adrenal Gland Diseases; Adrenocorticotropic Hormone; Adult; Cushing Syndrome; Dexamethasone; Humans; Hyperplasia; Hypothalamo-Hypophyseal System; Male; Pituitary-Adrenal System

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Animals; Blood Glucose; Cushing Syndrome; Dog Diseases; Dogs; Female; Glucocorticoids; Hypophysectomy; Iodine Radioisotopes; Male; Thyroid Function Tests; Thyrotropin

Topics: 17-Ketosteroids; Adrenalectomy; Aldosterone; Amines; Amino Acids; Androgens; Carbohydrates; Catecholamines; Chemical Phenomena; Chemistry; Chemistry, Clinical; Chromatography, Gas; Cushing Syndrome; Equipment and Supplies; Estrogens; Homocystinuria; Humans; Pregnanediol; Pregnenolone; Silicones; Steroids; Time Factors; Tryptamines

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adenoma; Adrenalectomy; Adult; Bronchial Neoplasms; Carcinoid Tumor; Cushing Syndrome; Female; Glucocorticoids; Humans; Hydrocortisone; Hydroxyindoleacetic Acid; Rib Fractures; Serotonin

Topics: 17-Ketosteroids; Adrenal Cortex Hormones; Adrenal Gland Neoplasms; Adult; Androgens; Androstanes; Carbon Isotopes; Chemistry, Clinical; Cushing Syndrome; Female; Humans; Hydrocortisone; Male; Secretory Rate; Tritium; Turner Syndrome

Topics: 17-Ketosteroids; Adrenal Gland Neoplasms; Adrenal Glands; Adult; Angiography; Carcinoma; Child; Cushing Syndrome; Female; Humans; Hypertension; Male; Middle Aged; Neoplasm Recurrence, Local; Neoplasms, Multiple Primary; Pheochromocytoma; Renal Artery; Surgical Procedures, Operative; Thymoma; Urography; Vena Cava, Inferior

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenal Gland Neoplasms; Androsterone; Aniline Compounds; Carcinoma; Cushing Syndrome; Etiocholanolone; Female; Humans; Middle Aged; Neoplasm Metastasis; Pyridones; Retroperitoneal Neoplasms; Steroids

Topics: 17-Ketosteroids; Adolescent; Adult; Cortisone; Cushing Syndrome; Female; Glucocorticoids; Humans; Male; Middle Aged

Topics: 17-Ketosteroids; Adrenal Glands; Aminoglutethimide; Aniline Compounds; Anticonvulsants; Cushing Syndrome; Humans; Hyperaldosteronism; Potassium; Pyridones; Sodium; Spironolactone; Steroids

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Abnormalities, Multiple; Adenoma; Adrenal Gland Neoplasms; Carcinoma; Child, Preschool; Cushing Syndrome; Dexamethasone; Female; Growth; Humans; Hydrocortisone; Hypertrophy; Infant; Infant, Newborn; Insulin; Male; Metyrapone; Pituitary-Adrenal Function Tests; Radiography; Sepsis

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenal Hyperplasia, Congenital; Adult; Androsterone; Cushing Syndrome; Diagnosis, Differential; Female; Hirsutism; Humans; Polycystic Ovary Syndrome; Pregnanetriol

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenal Hyperplasia, Congenital; Chemistry, Clinical; Child; Child, Preschool; Chromatography, Paper; Clitoris; Cushing Syndrome; Female; Hirsutism; Humans; Infant; Infant, Newborn; Male; Metabolism, Inborn Errors; Methods; Mixed Function Oxygenases; Pituitary-Adrenal Function Tests; Pregnanetriol; Sex Chromosome Aberrations; Urogenital Abnormalities

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adult; Chromatography; Chromatography, Gas; Chromatography, Paper; Chromatography, Thin Layer; Cushing Syndrome; Female; Humans; Hydrocortisone; Male; Methods; Pregnanes; Tritium

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenocorticotropic Hormone; Adult; Aminoglutethimide; Aniline Compounds; Anticonvulsants; Bicarbonates; Chemistry, Clinical; Cushing Syndrome; Dexamethasone; Growth Hormone; Hormones, Ectopic; Humans; Hydrocortisone; Male; Melanocyte-Stimulating Hormones; Potassium; Pyridones; Sodium; Thyroid Function Tests; Thyroxine-Binding Proteins; Uric Acid

Topics: 17-Ketosteroids; Acromegaly; Adrenal Cortex Hormones; Adrenocorticotropic Hormone; Adult; Animals; Breast Neoplasms; Cushing Syndrome; Diabetic Retinopathy; Dogs; Female; Humans; Hydrocortisone; Male; Methods; Middle Aged; Pituitary Gland; Prostatic Neoplasms; Ultrasonic Therapy

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenocorticotropic Hormone; Cushing Syndrome; Female; Humans; Middle Aged; Neoplasm Metastasis; Radiography, Thoracic; Skull; Thymus Neoplasms

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenocorticotropic Hormone; Basal Metabolism; Blood Proteins; Chemistry, Clinical; Cushing Syndrome; Dexamethasone; Female; Graves Disease; Humans; Hydrocortisone; Hyperplasia; Iodine; Iodine Radioisotopes; Middle Aged; Pituitary-Adrenal Function Tests; Protein Binding; Thyroid Function Tests; Thyroid Hormones; Transcortin

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenalectomy; Adrenocorticotropic Hormone; Adult; Carcinoma; Cushing Syndrome; Dexamethasone; Female; Hormones, Ectopic; Humans; Lymphatic Metastasis; Male; Metyrapone; Pheochromocytoma; Thyroid Neoplasms; Thyroidectomy

Topics: 17-Ketosteroids; Adrenal Cortex Hormones; Adrenocorticotropic Hormone; Adult; Blood Glucose; Blood Pressure; Body Height; Body Weight; Cushing Syndrome; Diabetes Complications; Diabetes Mellitus; Fasting; Female; Fluorometry; Glucocorticoids; Glucose Tolerance Test; Humans; Insulin; Islets of Langerhans; Male; Middle Aged

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adenoma, Islet Cell; Adrenocorticotropic Hormone; Adult; Aged; Biological Assay; Carcinoma, Squamous Cell; Child; Cushing Syndrome; Female; Humans; Lung Neoplasms; Pancreatic Neoplasms; Radioimmunoassay; Thymoma

Topics: 17-Ketosteroids; Adolescent; Adrenal Gland Diseases; Adrenal Gland Neoplasms; Adrenocortical Hyperfunction; Adrenocorticotropic Hormone; Adult; Cushing Syndrome; Dexamethasone; Female; Humans; Hyperplasia; Male; Metyrapone; Pituitary-Adrenal Function Tests; Pregnanes

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Addison Disease; Adrenal Gland Neoplasms; Adrenal Insufficiency; Adrenocortical Hyperfunction; Adrenocorticotropic Hormone; Cushing Syndrome; Dexamethasone; Humans; Hydrocortisone; Hypopituitarism; Hypothalamo-Hypophyseal System; Methods; Metyrapone; Pituitary-Adrenal Function Tests; Pregnanediol; Pregnanetriol; Stimulation, Chemical

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adult; Creatinine; Cushing Syndrome; Depression, Chemical; Dexamethasone; Edema; Female; Humans; Injections, Intravenous; Lymphoma, Large B-Cell, Diffuse; Male; Middle Aged; Nephrotic Syndrome; Pituitary-Adrenal System; Prednisone; Sarcoidosis

Topics: 17-Ketosteroids; Adrenal Hyperplasia, Congenital; Adult; Breast Neoplasms; Child; Chromatography, Gas; Cushing Syndrome; Etiocholanolone; Female; Humans; Hypopituitarism; Male; Methods; Pheochromocytoma; Polycystic Ovary Syndrome; Pregnanes; Statistics as Topic; Steroids

Topics: 17-Ketosteroids; Adrenal Cortex Hormones; Adrenal Gland Diseases; Adrenal Gland Neoplasms; Adrenal Glands; Adrenal Insufficiency; Aminoglutethimide; Aniline Compounds; Anticonvulsants; Cushing Syndrome; Female; Hematoma; Hirsutism; Humans; Hyperaldosteronism; Hypothyroidism; Male; Necrosis; Pyridones

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenal Gland Neoplasms; Adrenal Hyperplasia, Congenital; Adrenocortical Hyperfunction; Adult; Child; Chromatography, Paper; Cushing Syndrome; Female; Glucuronidase; Humans; Hydroxysteroid Dehydrogenases; Male; Methods; Middle Aged; Pregnanetriol; Pseudomonas

Topics: 17-Ketosteroids; Adenocarcinoma; Adenoma; Adrenal Gland Neoplasms; Cushing Syndrome; Female; Humans

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Acromegaly; Addison Disease; Adolescent; Adrenal Cortex Hormones; Adrenal Gland Neoplasms; Adrenal Hyperplasia, Congenital; Adult; Anorexia Nervosa; Child; Child, Preschool; Chromatography; Cushing Syndrome; Disorders of Sex Development; Endocrine System Diseases; Female; Humans; Hydrocortisone; Hyperaldosteronism; Hyperthyroidism; Hypertrichosis; Hypopituitarism; Male; Middle Aged; Myxedema; Obesity; Pheochromocytoma; Pregnancy; Spectrophotometry

Topics: 17-Ketosteroids; Alkaline Phosphatase; Cushing Syndrome; Endocrine System Diseases; Female; Humans; Male; Neutrophils; Obesity

Topics: 17-Ketosteroids; Cushing Syndrome; Humans; Hydrocortisone; Hypothalamus

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenal Gland Neoplasms; Adrenal Hyperplasia, Congenital; Adrenocortical Hyperfunction; Adult; Cushing Syndrome; Diagnosis, Differential; Glucocorticoids; Humans; Hyperaldosteronism; Middle Aged

Topics: 17-Ketosteroids; Adolescent; Adrenal Gland Neoplasms; Adrenal Hyperplasia, Congenital; Adult; Child, Preschool; Cushing Syndrome; Endocrine Glands; Female; Genital Neoplasms, Female; Gonadal Steroid Hormones; Hirsutism; Humans; Male; Middle Aged; Pituitary-Adrenal Function Tests; Polycystic Ovary Syndrome; Testosterone; Virilism

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenal Gland Neoplasms; Adrenalectomy; Cushing Syndrome; Dopamine; Ganglioneuroma; Humans; Hypokalemia; Infant; Male; Norepinephrine

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adolescent; Adult; Blood Glucose; Calcium; Cerebrospinal Fluid Rhinorrhea; Cushing Syndrome; Dexamethasone; Diabetes Insipidus; Female; Gonads; Humans; Hyperpituitarism; Male; Meningoencephalitis; Middle Aged; Pituitary Function Tests; Pituitary Irradiation; Pituitary-Adrenal System; Prognosis; Sella Turcica; Yttrium Isotopes

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adult; Arthritis, Infectious; Cushing Syndrome; Diagnosis, Differential; Humans; Male; Osteomyelitis; Penicillin G

Topics: 17-Ketosteroids; Adenoma, Chromophobe; Cushing Syndrome; Diabetic Nephropathies; Female; Heart Diseases; Humans; Hydrocortisone; Middle Aged; Pituitary Neoplasms

Topics: 17-Ketosteroids; Cushing Syndrome; Dexamethasone; Humans; Metyrapone; Yttrium Isotopes

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adolescent; Adrenal Glands; Adrenocortical Hyperfunction; Adult; Aminoglutethimide; Anticonvulsants; Cushing Syndrome; Female; Humans; Hydrocortisone; Middle Aged; Natriuresis; Secretory Rate

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenal Glands; Adrenocortical Hyperfunction; Adult; Cushing Syndrome; Female; Humans; Male; Phenethylamines; Testosterone

Topics: 17-Ketosteroids; Adrenal Hyperplasia, Congenital; Androsterone; Chromatography, Gas; Cushing Syndrome; Dehydroepiandrosterone; Disorders of Sex Development; Etiocholanolone; Female; Hirsutism; Humans; Klinefelter Syndrome; Male; Polycystic Ovary Syndrome; Pregnanediol; Pregnanetriol; Testicular Neoplasms; Turner Syndrome

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenal Gland Diseases; Cushing Syndrome; Dehydroepiandrosterone; Female; Hirsutism; Humans; Hyperplasia; Infertility, Female; Male; Polycystic Ovary Syndrome; Testosterone

Topics: 17-Ketosteroids; Adolescent; Adrenal Gland Neoplasms; Adrenocortical Hyperfunction; Adult; Androstanes; Androsterone; Carcinoma; Chemistry, Clinical; Chromatography, Thin Layer; Cushing Syndrome; Dehydroepiandrosterone; Etiocholanolone; Female; Humans; Kidney Neoplasms; Lung Neoplasms; Male; Methods; Ovarian Diseases; Testicular Neoplasms

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenocorticotropic Hormone; Adult; Alkalosis; Bronchial Neoplasms; Cushing Syndrome; Dexamethasone; Female; Fluorescent Antibody Technique; Humans; Hypokalemia; Hypophysectomy; Lung Neoplasms; Pigmentation Disorders

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adenoma; Adrenal Gland Neoplasms; Adrenocortical Hyperfunction; Adrenocorticotropic Hormone; Adult; Aminoglutethimide; Animals; Anticoagulants; Carcinoma; Cushing Syndrome; Female; Humans; Hydrocortisone; Metyrapone; Middle Aged; Pituitary-Adrenal Function Tests; Secretory Rate

Topics: 17-Ketosteroids; Adrenal Insufficiency; Adrenalectomy; Adrenocorticotropic Hormone; Adult; Aldosterone; Cushing Syndrome; Diet, Sodium-Restricted; Diuresis; Humans; Hydrocortisone; Male; Natriuresis; Pituitary Neoplasms; Pituitary-Adrenal Function Tests; Pituitary-Adrenal System; Potassium; Radiography; Secretory Rate; Sella Turcica; Sodium; Urea

Topics: 17-Ketosteroids; Adrenal Hyperplasia, Congenital; Adrenocorticotropic Hormone; Cushing Syndrome; Female; Hirsutism; Humans; Hypogonadism; Male; Metyrapone; Polycystic Ovary Syndrome; Prednisolone; Testosterone

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenocorticotropic Hormone; Carcinoid Tumor; Cushing Syndrome; Dexamethasone; Humans; Hyperglycemia; Lung Neoplasms; Male; Metyrapone; Middle Aged; Radiography, Thoracic

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adenoma; Adrenal Cortex Hormones; Adrenal Gland Neoplasms; Adrenal Insufficiency; Adrenalectomy; Adrenocorticotropic Hormone; Adult; Aldosterone; Cushing Syndrome; Female; Humans; Middle Aged; Postoperative Complications

Topics: 17-Ketosteroids; Adipose Tissue; Adolescent; Adult; Body Composition; Body Weight; Cushing Syndrome; Extracellular Space; Female; Follow-Up Studies; Humans; Hydrocortisone; Male; Middle Aged; Potassium; Radioisotope Dilution Technique

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adolescent; Adrenal Cortex Hormones; Adrenal Gland Neoplasms; Adrenocortical Hyperfunction; Adult; Cushing Syndrome; Female; Humans; Hydrocortisone; Male; Middle Aged; Obesity; Peptic Ulcer; Secretory Rate

Topics: 17-Ketosteroids; Adenoma; Adrenal Gland Neoplasms; Adrenal Hyperplasia, Congenital; Adrenalectomy; Adrenocortical Hyperfunction; Adult; Carcinoma; Child; Child, Preschool; Cushing Syndrome; Female; Humans; Hyperaldosteronism; Hypertension; Intestinal Polyps; Male; Pheochromocytoma

Topics: 17-Ketosteroids; Acromegaly; Animals; Bone Neoplasms; Breast Neoplasms; Cushing Syndrome; Diabetic Retinopathy; Dogs; Female; Humans; Hypophysectomy; Male; Methods; Neoplasm Metastasis; Pituitary Gland; Prostatic Neoplasms; Ultrasonic Therapy

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenalectomy; Cushing Syndrome; Female; Humans; Middle Aged

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenalectomy; Adult; Circadian Rhythm; Cushing Syndrome; Humans; Male

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Bronchial Neoplasms; Cobalt Isotopes; Cushing Syndrome; Female; Hemorrhagic Disorders; Humans; Hypothyroidism; Middle Aged; Neoplasm Recurrence, Local; Radioisotope Teletherapy; Thyroid Neoplasms

Topics: 17-Ketosteroids; Adult; Cortisone; Cushing Syndrome; Humans; Prednisone

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adolescent; Adult; Cushing Syndrome; Female; Humans; Male; Pituitary-Adrenal Function Tests; Pyruvates

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenal Gland Neoplasms; Adrenal Insufficiency; Adrenocortical Hyperfunction; Adrenocorticotropic Hormone; Antineoplastic Agents; Cushing Syndrome; Dichlorodiphenyldichloroethane; Female; Humans; Male

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenal Gland Neoplasms; Adrenocortical Hyperfunction; Adrenocorticotropic Hormone; Adult; Aged; Cushing Syndrome; Dexamethasone; Female; Humans; Male; Metyrapone; Middle Aged; Pituitary Function Tests; Pituitary-Adrenal Function Tests; Pregnanediol; Pregnanetriol; Urine

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenalectomy; Adrenocorticotropic Hormone; Adult; Cushing Syndrome; Dexamethasone; Humans; Male; Middle Aged; Postoperative Care; Urine

Topics: 17-Ketosteroids; Adrenocorticotropic Hormone; Adult; Bicarbonates; Blood Glucose; Bronchial Neoplasms; Carcinoma; Corticosterone; Cushing Syndrome; Dexamethasone; Female; Humans; Hydrocortisone; Male; Middle Aged; Pituitary Function Tests; Pituitary-Adrenal Function Tests; Potassium

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Addison Disease; Adrenal Gland Diseases; Adrenal Glands; Adrenalectomy; Adrenocorticotropic Hormone; Adult; Animals; Cushing Syndrome; Estradiol; Female; Humans; Hydrocortisone; Middle Aged; Placenta; Pre-Eclampsia; Pregnancy; Pregnancy Complications; Pregnanetriol; Rats

Topics: 17-Ketosteroids; Adrenal Gland Neoplasms; Blood; Child; Corticosterone; Cortisone; Cushing Syndrome; Dexamethasone; Female; Gonadotropins, Pituitary; Humans; Hydrocortisone; Pituitary Function Tests

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenal Gland Neoplasms; Cushing Syndrome; Dexamethasone; Female; Growth Hormone; Humans; Hydrocortisone; Hypoglycemia; Insulin; Pituitary-Adrenal Function Tests

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adolescent; Adrenal Gland Neoplasms; Adult; Aged; Antineoplastic Agents; Black or African American; Carcinoma; Child; Child, Preschool; Cushing Syndrome; Dichlorodiphenyldichloroethane; Female; Humans; Infant; Male; Middle Aged; Neoplasm Metastasis; Sex; White People

Topics: 17-Ketosteroids; Adolescent; Adrenal Hyperplasia, Congenital; Child; Child, Preschool; Cushing Syndrome; Female; Humans; Male; Puberty, Precocious

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adolescent; Child Behavior Disorders; Cushing Syndrome; Diagnosis, Differential; Humans; Laurence-Moon Syndrome; Male; Mental Disorders; Urine

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenal Gland Neoplasms; Cushing Syndrome; Diabetes Mellitus; Female; Humans; Hyperplasia; Hypertension; Infant; Infant, Newborn; Male; Obesity; Osteoporosis

Topics: 17-Ketosteroids; Chromatography, Gas; Cushing Syndrome; Female; Humans; Hypogonadism; Male; Polycystic Ovary Syndrome

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenal Gland Diseases; Child; Cushing Syndrome; Dichlorodiphenyldichloroethane; Electroencephalography; Female; Humans; Hyperplasia

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenal Cortex Hormones; Cushing Syndrome; Female; Humans; Middle Aged; Pituitary Neoplasms; Pituitary-Adrenal System

The isotopic estimation of the cortisol secretion rate in man is now an accepted and reliable method of assaying adrenal cortical function.Seven years' experience with its clinical use is reviewed and some practical aspects of technique are considered. The mean normal resting cortisol secretion rate is 16.2 +/- 5.7 mg. daily. In all of 14 cases of hypopituitarism studied secretion has been less than 2.1 mg. daily. In all of 26 cases of established Cushing's syndrome, the cortisol secretion was above 36 mg. The method can be used to follow day-by-day changes in adrenal cortisol activity and examples of such use are given. The urinary 17-ketogenic steroid excretion frequently gives results which conflict with secretion rate estimates, and can lead to erroneous clinical conclusions.

Topics: 17-Ketosteroids; Addison Disease; Adrenal Cortex Hormones; Adrenocortical Hyperfunction; Carbon Isotopes; Cushing Syndrome; Humans; Hydrocortisone; Hypopituitarism; Physiology; Pituitary-Adrenal Function Tests; Tritium; Urine

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenal Gland Neoplasms; Adrenocortical Carcinoma; Aldosterone; Anabolic Agents; Androsterone; Cushing Syndrome; Dexamethasone; Etiocholanolone; Humans; Hydrocortisone; Hypoglycemia; Leucine; Manganese; Pathology; Steroids; Tolbutamide; Urine

Topics: 17-Ketosteroids; Adrenal Cortex Hormones; Adrenal Gland Neoplasms; Amenorrhea; Androsterone; Blood Chemical Analysis; Chromatography; Cushing Syndrome; Dehydroepiandrosterone; Drug Therapy; Female; Hirsutism; Humans; Hypertrichosis; Polycystic Ovary Syndrome; Surgical Procedures, Operative; Virilism

Topics: 17-Ketosteroids; Adolescent; Adrenalectomy; Adrenocortical Hyperfunction; Carbon Isotopes; Child; Cushing Syndrome; Humans; Hydrocortisone; Metabolism; Pituitary ACTH Hypersecretion; Pituitary Irradiation; Pituitary-Adrenal Function Tests

Topics: 17-Ketosteroids; Adrenal Cortex Hormones; Adrenocortical Hyperfunction; Adrenocorticotropic Hormone; Chromatography, Gel; Colorimetry; Cryptorchidism; Cushing Syndrome; Fluorometry; Humans; Hydrocortisone; Male; Urine

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenalectomy; Cushing Syndrome; Estradiol; Estriol; Estrogens; Estrone; Female; Humans; Maternal-Fetal Exchange; Pregnancy; Pregnancy Complications; Pregnanediol; Urine

Topics: 17-Ketosteroids; Chemical Fractionation; Chromatography; Cushing Syndrome; Humans; Obesity; Obesity, Morbid; Urine

Topics: 17-Ketosteroids; Adrenalectomy; Adrenocorticotropic Hormone; Cushing Syndrome; Dexamethasone; Humans; Hypophysectomy; Melanocyte-Stimulating Hormones; Metyrapone; Urine

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Acromegaly; Basal Metabolism; Breast Neoplasms; Cushing Syndrome; Diabetes Mellitus; Gonadotropins; Gonadotropins, Pituitary; Humans; Hypopituitarism; Metyrapone; Pituitary Diseases; Pituitary Gland; Pituitary Irradiation; Thyroid Function Tests; Urine; Yttrium Isotopes

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenocortical Hyperfunction; Adrenocorticotropic Hormone; Blood; Cushing Syndrome; Humans; Hydrocortisone; Pathology; Urine

The production of ACTH-like material by tumours arising in non-endocrine tissue may initiate severe adrenocortical hyperfunction. The pathogenesis and clinical and laboratory features of Cushing's syndrome associated with such tumours are characteristic. The autonomous production by the tumour of ACTH-like material cannot be suppressed by exogenous corticoids. The onset of clinical symptoms is rapid; muscle wasting, general weakness, thirst and peripheral edema predominate, and the classical signs of Cushing's syndrome may be absent. High levels of plasma 17-hydroxycorticosteroids and urinary 17-hydroxycorticosteroids and 17-ketosteroids, usually with normal levels of urinary aldosterone, commonly occur. Hypokalemic alkalosis unresponsive to replacement therapy may cause death. In the case reported herein, the intriguing possibility exists that two hormone-like substances were produced by the primary growth and its metastases: one, ACTH-like, to account for the adrenal hyperplasia and Cushing's syndrome; and another, gastrin-like, giving rise to the ulcerogenic diathesis.

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adenoma, Islet Cell; Adrenalectomy; Adrenocortical Hyperfunction; Autopsy; Carcinoma, Islet Cell; Chloramphenicol; Cushing Syndrome; Drug Therapy; Gastrins; Humans; Hypokalemia; Neoplasm Metastasis; Neoplasms; Pancreatic Neoplasms; Pathology; Spironolactone; Zollinger-Ellison Syndrome

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adolescent; Adrenocorticotropic Hormone; Anorexia Nervosa; Brain; Cushing Syndrome; Humans; Hydrocortisone; Hypothalamus; Urine

Topics: 17-Ketosteroids; Acromegaly; Addison Disease; Adenoma; Adolescent; Adrenal Hyperplasia, Congenital; Adult; Blood; Child; Chromatography, Gas; Cushing Syndrome; Female; Glucuronates; Hirsutism; Humans; Hypogonadism; Klinefelter Syndrome; Male; Middle Aged; Polycystic Ovary Syndrome; Testosterone; Urine

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adolescent; Adrenalectomy; Adrenocortical Hyperfunction; Adult; Cushing Syndrome; Dietary Proteins; Fasting; Female; Humans; Hydrocortisone; In Vitro Techniques; Male; Obesity; Urine

Topics: 17-Ketosteroids; Adenoma, Chromophobe; Adrenalectomy; Adult; Cushing Syndrome; Female; Humans; Pituitary Neoplasms

Topics: 17-Ketosteroids; Adrenal Cortex Hormones; Adrenal Gland Diseases; Adrenal Gland Neoplasms; Adrenal Hyperplasia, Congenital; Adrenalectomy; Adult; Breast Neoplasms; Child, Preschool; Cortisone; Cushing Syndrome; Disorders of Sex Development; Female; Humans; Hyperaldosteronism; Infant; Male; Pheochromocytoma; Prednisolone; Virilism

Topics: 17-Ketosteroids; Adrenal Cortex Hormones; Chromatography, Gas; Cushing Syndrome; Female; Humans; In Vitro Techniques; Male; Urine

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adolescent; Adult; Aldosterone; Corticosterone; Cushing Syndrome; Female; Humans; Hydrocortisone; In Vitro Techniques; Male; Middle Aged; Pituitary-Adrenal Function Tests; Urine

Topics: 17-Ketosteroids; Adenoma; Adenoma, Acidophil; Adenoma, Basophil; Adolescent; Adrenal Cortex Hormones; Adrenalectomy; Adrenocorticotropic Hormone; Aldosterone; Blood Chemical Analysis; Choristoma; Cushing Syndrome; Follicle Stimulating Hormone; Humans; Hydrocortisone; Hypophysectomy; Iodine Isotopes; Myxedema; Neoplasms; Pathology; Pituitary Neoplasms; Radiography; Radioisotopes; Radionuclide Imaging; Thyroid Function Tests; Urine

Topics: 17-Ketosteroids; Adrenal Cortex Hormones; Adrenal Gland Diseases; Adrenalectomy; Adrenocortical Hyperfunction; Adrenogenital Syndrome; Aldosterone; Androgens; Cushing Syndrome; Humans; Hyperplasia; Hypertrophy; Pathology; Pituitary-Adrenal Function Tests; Sympatholytics

Topics: 17-Ketosteroids; Adrenal Cortex Hormones; Adrenal Gland Neoplasms; Adrenalectomy; Adrenocorticotropic Hormone; Cortisone; Cushing Syndrome; Dexamethasone; Female; Fludrocortisone; Humans; Hydrocortisone; Hypertension; Physiology; Pituitary-Adrenal Function Tests; Urine; Virilism

Topics: 17-Ketosteroids; Adrenal Cortex; Adrenal Gland Neoplasms; Adrenal Hyperplasia, Congenital; Adrenogenital Syndrome; Anxiety; Cushing Syndrome; Diagnosis, Differential; Hypertension; Liver Neoplasms; Neoplasm Metastasis; Nephrectomy; Pathology; Urine; Urography

Topics: 17-Ketosteroids; Addison Disease; Adrenal Glands; Adrenocorticotropic Hormone; Adrenogenital Syndrome; Asthma; Carcinoma, Bronchogenic; Coccidioidomycosis; Cushing Syndrome; Diabetes Mellitus; Ethinyl Estradiol; Female; Humans; Hydrocortisone; Hyperaldosteronism; Hypopituitarism; Hypotension; Myocardial Infarction; Neurotic Disorders; Pituitary Neoplasms; Polycystic Ovary Syndrome

Topics: 17-Ketosteroids; Adenoma; Adrenal Cortex Hormones; Adrenal Gland Neoplasms; Cushing Syndrome; Female; Fetal Death; Humans; Infant, Newborn; Pituitary-Adrenal Function Tests; Pregnancy; Pregnancy Complications; Surgical Procedures, Operative; Urine

Topics: 17-Ketosteroids; Adrenal Cortex Hormones; Adrenal Gland Neoplasms; Adrenalectomy; Adrenocortical Hyperfunction; Adrenogenital Syndrome; Cushing Syndrome; Humans; Hyperaldosteronism; Pheochromocytoma

Topics: 17-Ketosteroids; Adrenal Cortex Hormones; Adrenalectomy; Adrenocorticotropic Hormone; Antineoplastic Agents; Blood; Child; Cushing Syndrome; Dichlorodiphenyldichloroethane; Humans; Obesity; Toxicology; Urine

Topics: 17-Ketosteroids; Adolescent; Adrenalectomy; Androgens; Androsterone; Blood Chemical Analysis; Breast Neoplasms; Carbon Isotopes; Castration; Chorionic Gonadotropin; Chromatography; Cushing Syndrome; Dehydroepiandrosterone; Dexamethasone; Female; Glucose; Gonadotropins; Humans; Male; Orchiectomy; Ovary; Testosterone

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Addison Disease; Adrenal Cortex Hormones; Adrenal Glands; Adrenal Insufficiency; Biomedical Research; Carbon Isotopes; Cushing Syndrome; Hydrocortisone; Hypoadrenocorticism, Familial; Metabolism; Physiology; Pituitary-Adrenal Function Tests; Urine

Topics: 17-Ketosteroids; Adenofibroma; Adolescent; Breast; Breast Neoplasms; Cushing Syndrome; Female; Fibroadenoma; Humans; Surgical Procedures, Operative; Urine

Topics: 17-Ketosteroids; Adrenal Cortex Hormones; Adrenalectomy; Adrenocortical Hyperfunction; Adrenocorticotropic Hormone; Blood Chemical Analysis; Cortisone; Cushing Syndrome; Dexamethasone; Humans; Hyperpigmentation; Pigmentation Disorders; Pituitary ACTH Hypersecretion

Topics: 17-Ketosteroids; Adrenal Gland Neoplasms; Adrenalectomy; Adrenocortical Hyperfunction; Adrenocorticotropic Hormone; Corticosterone; Cushing Syndrome; Dexamethasone; Disorders of Sex Development; Glucose Tolerance Test; Humans; Surgical Procedures, Operative; Urine

Topics: 17-Ketosteroids; Adrenalectomy; Adrenocortical Hyperfunction; Adrenocorticotropic Hormone; Corticosterone; Cushing Syndrome; Humans; Hyperplasia; Injections, Intramuscular; Suppositories; Urine

Topics: 17-Ketosteroids; Adrenal Cortex Hormones; Adrenal Gland Diseases; Adrenal Insufficiency; Anorexia Nervosa; Cushing Syndrome; Dexamethasone; Diabetes Mellitus; Humans; Hyperthyroidism; Periodicity; Pituitary Gland; Pituitary-Adrenal Function Tests; Statistics as Topic; Urine

Topics: 17-Ketosteroids; Adrenocorticotropic Hormone; Cushing Syndrome; Dexamethasone; Diagnosis, Differential; Humans; Metyrapone; Pathology; Pituitary-Adrenal Function Tests; Teaching Rounds; Urine

Topics: 17-Ketosteroids; Addison Disease; Adrenal Insufficiency; Adrenogenital Syndrome; Androgens; Cholesterol; Cushing Syndrome; Hypoadrenocorticism, Familial; Physiology; Pituitary-Adrenal Function Tests; Progestins; Urine

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenalectomy; Adrenocorticotropic Hormone; Biomedical Research; Blood; Body Fluids; Cortisone; Cushing Syndrome; Dexamethasone; Drug Therapy; Fludrocortisone; Humans; Pituitary-Adrenal Function Tests; Urine

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Addison Disease; Adrenal Insufficiency; Aging; Cushing Syndrome; Fluprednisolone; Hypoadrenocorticism, Familial; Hypopituitarism; Obesity; Pharmacology; Urine

Topics: 17-Ketosteroids; Adolescent; Cushing Syndrome; Humans; Hypertension; Obesity; Puberty; Sexual Maturation

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adenoma; Adrenalectomy; Adrenocorticotropic Hormone; Alkalosis; Bartter Syndrome; Bronchial Neoplasms; Cushing Syndrome; Dexamethasone; Heart Arrest; Humans; Hypokalemia; Metyrapone; Neoplasms; Neoplasms, Multiple Primary; Pathology; Radiography, Thoracic; Urine

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenocorticotropic Hormone; Betamethasone; Cushing Syndrome; Diagnosis, Differential; Fluids and Secretions; Hypertrichosis; Ketones; Metabolism; Metyrapone; Mineralocorticoid Receptor Antagonists; Obesity; Pituitary-Adrenal Function Tests; Urine

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenocorticotropic Hormone; Blood Chemical Analysis; Blood Pressure; Body Weight; Body Weights and Measures; Cushing Syndrome; Dexamethasone; Glucose Tolerance Test; Humans; Hydrocortisone; Metabolism; Obesity; Urine

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Addison Disease; Adrenal Insufficiency; Adrenalectomy; Antineoplastic Agents; Cushing Syndrome; Dichlorodiphenyldichloroethane; Drug Therapy; Humans; Hydrocortisone; Hypoadrenocorticism, Familial; Male; Metabolism; Mitotane; Urine

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenal Cortex; Adrenal Gland Diseases; Adrenal Hyperplasia, Congenital; Adrenocorticotropic Hormone; Adrenogenital Syndrome; Blood; Cushing Syndrome; Estrogens; Humans; Hyperplasia; Pharmacology; Pregnanetriol; Triamcinolone; Urine

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Addison Disease; Adrenal Cortex; Adrenal Gland Diseases; Adrenal Insufficiency; Adrenocortical Hyperfunction; Androsterone; Cushing Syndrome; Dehydroepiandrosterone; Humans; Hydrochlorothiazide; Hypoadrenocorticism, Familial; Hypopituitarism; Pharmacology; Pituitary-Adrenal Function Tests

Topics: 17-Ketosteroids; Acromegaly; Addison Disease; Adrenal Insufficiency; Cushing Syndrome; Endocrine System Diseases; Humans; Hyperthyroidism; Hypoadrenocorticism, Familial

Topics: 17-Ketosteroids; Cushing Syndrome; Dexamethasone

Topics: 17-Ketosteroids; Adrenal Gland Diseases; Adrenal Gland Neoplasms; Adrenalectomy; Adrenocortical Hyperfunction; Adrenocorticotropic Hormone; Blood Chemical Analysis; Chromatography; Cortisone; Cushing Syndrome; Dexamethasone; Humans; Hydrocortisone; Neoplasms; Pharmacology; Pituitary-Adrenal Function Tests; Urine

Topics: 17-Ketosteroids; Adolescent; Adrenal Cortex; Adrenocorticotropic Hormone; Blood Chemical Analysis; Cushing Syndrome; Dexamethasone; Hydrocortisone; Klinefelter Syndrome; Obesity; Pharmacology; Pituitary-Adrenal Function Tests; Urine

Topics: 17-Ketosteroids; Adrenal Cortex Hormones; Adrenalectomy; Adrenocortical Hyperfunction; Cushing Syndrome; Humans; Hypophysectomy; Osteoporosis; Pituitary ACTH Hypersecretion; Radiography

Topics: 17-Ketosteroids; Adolescent; Adrenal Cortex Hormones; Amenorrhea; Body Height; Body Weight; Cushing Syndrome; Female; Fludrocortisone; Humans; Obesity; Urine

Topics: 17-Ketosteroids; Adenoma; Adenoma, Chromophobe; Adolescent; Adrenal Cortex Hormones; Adrenal Hyperplasia, Congenital; Adrenalectomy; Adrenocorticotropic Hormone; Adrenogenital Syndrome; Blood Chemical Analysis; Cushing Syndrome; Dexamethasone; Humans; Male; Progesterone; Testicular Neoplasms; Urine

Topics: 17-Ketosteroids; Adrenal Cortex Hormones; Adrenal Gland Neoplasms; Adrenocortical Carcinoma; Cushing Syndrome; Ketones; Metyrapone; Mineralocorticoid Receptor Antagonists; Urine

Topics: 17-Ketosteroids; Adrenocorticotropic Hormone; Androgens; Androsterone; Carcinoma; Carcinoma, Bronchogenic; Chromatography; Cushing Syndrome; Dehydroepiandrosterone; Etiocholanolone; Geriatrics; Humans; Kidney Function Tests; Neoplasms

Topics: 17-Ketosteroids; Adenoma; Adrenal Cortex Hormones; Adrenal Hyperplasia, Congenital; Adrenocortical Hyperfunction; Adrenocorticotropic Hormone; Adrenogenital Syndrome; Aldosterone; Cholesterol; Cushing Syndrome; Follicle Stimulating Hormone; Humans; Metabolism; Pituitary-Adrenal Function Tests; Pregnanediol

Topics: 17-Ketosteroids; Adrenal Medulla; Adrenalectomy; Cortisone; Cushing Syndrome; Epinephrine; Hypotension; Hypotension, Orthostatic

Topics: 17-Ketosteroids; Addison Disease; Adrenal Cortex Hormones; Adrenal Gland Neoplasms; Adrenal Glands; Adrenocortical Hyperfunction; Cushing Syndrome; Humans; Hypopituitarism; Ketones; Metyrapone; Mineralocorticoid Receptor Antagonists; Physiology; Pituitary Gland; Pituitary-Adrenal Function Tests

Topics: 17-Ketosteroids; Adolescent; Adrenal Cortex Hormones; Adrenal Gland Diseases; Adrenocorticotropic Hormone; Blood Pressure Determination; Cushing Syndrome; Diagnosis, Differential; Endocrinology; Estrogens; Ketones; Metyrapone; Mineralocorticoid Receptor Antagonists; Urine

Topics: 17-Ketosteroids; Adrenal Cortex Hormones; Adrenal Gland Diseases; Androsterone; Cushing Syndrome; Estradiol; Estriol; Estrogens; Estrone; Etiocholanolone; Female; Hirsutism; Humans; Hypertrichosis; Ovary; Pregnanediol; Steroids; Urine; Virilism

Topics: 17-Ketosteroids; Adrenal Gland Neoplasms; Adrenal Hyperplasia, Congenital; Adrenogenital Syndrome; Child; Cushing Syndrome; Gonads; Humans; Male; Pathology; Surgical Procedures, Operative; Testis; Urine

Topics: 17-Ketosteroids; Addison Disease; Adolescent; Adrenal Cortex; Adrenal Cortex Hormones; Adrenal Insufficiency; Adrenalectomy; Adrenocorticotropic Hormone; Cosyntropin; Cushing Syndrome; Hypertrichosis; Hypoadrenocorticism, Familial; Pituitary-Adrenal Function Tests; Urine

Topics: 17-Ketosteroids; Acromegaly; Adrenocortical Hyperfunction; Adrenocorticotropic Hormone; Clinical Laboratory Techniques; Cushing Syndrome; Cysts; Female; Humans; Hypogonadism; Hypopituitarism; Metyrapone; Mineralocorticoid Receptor Antagonists; Neoplasms; Ovary; Pharmacology; Pituitary Gland; Pituitary Neoplasms; Radioisotope Teletherapy; Scleroderma, Systemic; Sexual Infantilism; Toxicology; Urine

Topics: 17-Ketosteroids; Adrenal Cortex Hormones; Cushing Syndrome; Humans

Topics: 17-Ketosteroids; Adenoma, Islet Cell; Adrenocorticotropic Hormone; Blood; Cushing Syndrome; Dexamethasone; Endocrinology; Humans; Lung Neoplasms; Mediastinal Neoplasms; Pancreatic Neoplasms; Parotid Neoplasms; Peptides; Pheochromocytoma; Urine

Topics: 17-Ketosteroids; Biological Transport; Cushing Syndrome; Humans

Topics: 17-Ketosteroids; Adenoma; Adrenal Cortex Hormones; Cushing Syndrome; Humans; Hyperplasia

Topics: 17-Ketosteroids; Adrenal Cortex; Adrenal Cortex Diseases; Body Fluids; Cushing Syndrome; Hormones; Humans; Hyperplasia

Topics: 17-Ketosteroids; Adrenal Cortex Hormones; Adrenocortical Hyperfunction; Cushing Syndrome; Humans; Steroids

Topics: 17-Ketosteroids; Adrenal Cortex Hormones; Biological Transport; Body Fluids; Cushing Syndrome; Humans; Steroids

Topics: 17-Ketosteroids; Biological Transport; Body Fluids; Cushing Syndrome; Humans; Steroids

Topics: 17-Ketosteroids; Adrenal Cortex; Adrenal Cortex Hormones; Body Fluids; Cushing Syndrome; Humans

Topics: 17-Ketosteroids; Adrenal Cortex; Adrenal Cortex Hormones; Adrenocorticotropic Hormone; Body Fluids; Chromatography; Cushing Syndrome; Humans

Topics: 17-Ketosteroids; Adrenal Cortex; Adrenal Cortex Neoplasms; Body Fluids; Cushing Syndrome; Humans; Urinary Tract

Topics: 17-Ketosteroids; Adrenal Cortex Hormones; Adrenocorticotropic Hormone; Cushing Syndrome; Humans

Topics: 17-Ketosteroids; Body Fluids; Cushing Syndrome; Humans; Steroids

Topics: 17-Ketosteroids; Adrenocortical Hyperfunction; Cushing Syndrome; Dose Fractionation, Radiation; Hormones; Humans; Pituitary ACTH Hypersecretion; Urinary Tract

Topics: 17-Ketosteroids; Adrenal Cortex; Adrenal Cortex Diseases; Adrenal Hyperplasia, Congenital; Adrenogenital Syndrome; Cushing Syndrome; Hormones; Hydrocortisone

Topics: 17-Ketosteroids; Acromegaly; Addison Disease; Adrenal Hyperplasia, Congenital; Adrenocortical Hyperfunction; Androgens; Cushing Syndrome; Dehydroepiandrosterone; Endocrine System Diseases; Humans; Pituitary ACTH Hypersecretion; Puberty, Precocious; Steroids; Urine

Topics: 17-Ketosteroids; Body Fluids; Cortisone; Cushing Syndrome; Humans; Steroids; Urine

Topics: 17-Ketosteroids; Adrenal Cortex; Adrenal Cortex Diseases; Body Fluids; Cushing Syndrome; Humans; Neoplasms; Steroids

Topics: 17-Ketosteroids; Adrenal Cortex; Adrenal Cortex Hormones; Adrenocortical Hyperfunction; Body Fluids; Cushing Syndrome; Humans; Radiotherapy; Steroids; Urine; X-Ray Therapy

Topics: 17-Ketosteroids; Adrenal Gland Diseases; Adrenal Gland Neoplasms; Adrenal Hyperplasia, Congenital; Adrenocortical Hyperfunction; Cushing Syndrome; Humans; Hyperplasia

The urinary 17-ketosteroids are a group of compounds derived from complex steroids produced by the adrenal cortex, testis, or ovary. The method of determining the amount excreted has been simplified so that it is available for routine diagnostic purposes. Usually the amount is increased in diseases in which there is hyperfunction of the adrenal cortex due to tumor or hyperplasia, and decreased in lesions that impair the function of the adrenal cortex. Other conditions such as myxedema, eunuchism, gout, and arthritis may alter the excretion of the 17-ketosteroids. Low levels are also found in the young and in the aged. Case histories are presented to illustrate the findings in the following diseases: Tumors of the adrenal cortex with (a) masculinization, (b) Cushing's syndrome with virilism and, (c) hirsutism; as well as in gigantism with acromegaly, in gout, eunuchism, Addison's disease, myxedema, and severe panhypopituitarism.

Topics: 17-Ketosteroids; Adrenal Cortex; Cushing Syndrome; Endocrine System Diseases; Female; Hirsutism; Humans; Hyperplasia; Male; Ovary; Steroids; Urine; Virilism