atrial-natriuretic-factor and ACTH-Syndrome--Ectopic

The term paraneoplastic syndrome refers to the ability of some tumors to produce signs and symptoms at a distance from the site of the primary tumor or its metastases. Paraneoplastic syndromes may develop before the diagnosis of carcinoma is made. Paraneoplastic syndromes associated with small cell lung cancer (SCLC) include endocrinologic abnormalities secondary to peptide hormone production, and neurologic sequelae due to autoantibody production. This article reviews the common paraneoplastic syndromes that may occur in patients with SCLC.

Topics: ACTH Syndrome, Ectopic; Atrial Natriuretic Factor; Carcinoma, Small Cell; Cerebellar Diseases; Encephalomyelitis; Humans; Inappropriate ADH Syndrome; Lambert-Eaton Myasthenic Syndrome; Lung Neoplasms; Paraneoplastic Syndromes; Retinal Diseases

In vitro studies have shown that glucocorticoids may increase atrial natriuretic-hormone (ANH) synthesis and/or release. This action of glucocorticoids has also been suggested in vivo in patients with Cushing's syndrome. However, in this circumstance, plasma AH elevation might be due to humoral disturbances associated with cortisol overproduction. We studied 16 patients with endogenous hypercorticism and 11 of them after successful treatment. Plasma levels of ANH, plasma renin activity (PRA), aldosterone, desoxycorticosterone (DOC), angiotensin II (AII), cortisol, osmolarity, sodium and potassium, urinary free cortisol (UFC), and blood pressure were measured. Before treatment the mean plasma ANH concentration in patients with Cushing's syndrome was significantly higher than in controls (11.3 +/- 2.6 vs. 4.9 +/- 2.3 pmol/l; p less than 0.001). ANH was correlated with cortisol and UFC (r = 0.715, r = 0.700; p less than 0.05). There was no significant correlation between plasma ANH, PRA, aldosterone, DOC, AII, osmolarity, sodium or blood pressure. After recovery, ANH concentration decreased in all patients and was not different from that of normal subjects (4.9 +/- 2.3 vs. 4.3 +/- 2.6 pmol/l). These results suggest that in Cushing's syndrome, ANH secretion is mainly dependent on the severity of hypercortisolism and independent of the other associated disturbances that we studied.

Topics: ACTH Syndrome, Ectopic; Adenoma; Adrenal Cortex Diseases; Adrenal Cortex Neoplasms; Adrenocortical Hyperfunction; Adult; Angiotensin II; Atrial Natriuretic Factor; Cushing Syndrome; Desoxycorticosterone; Humans