cosyntropin and Remission--Spontaneous

A 13-year-old girl who had been well previously was admitted with fulminant meningococcemic purpura. Her plasma cortisol level was only 3 micrograms/dL and failed to rise after cosyntropin administration. Maintenance doses of corticosteroid were administered. As her infection cleared her adrenal glands were restimulated and shown to have near normal response. Replacement doses of corticosteroids should be given to patients with fulminant meningococcemia until adrenal cortical insufficiency can be excluded because of the high incidence of adrenal failure in these patients and the possibility that excessive adrenal stimulation might contribute to adrenal abnormality.

Topics: Adolescent; Adrenal Cortex Hormones; Adrenal Insufficiency; Cosyntropin; Female; Humans; Hydrocortisone; Meningitis, Meningococcal; Neisseria meningitidis; Remission, Spontaneous

The experience of the authors demonstrated that the best results in sinakten-retard treatment were attained in patients with mild and moderate degrees of severity of the disease. However, even in patients with a protracted development, treatment by sinakten-retard increased the muscular strength in the paralyzed extremities, diminished the increased muscular tone and increased the volume of movements. All these facts permit the authors to recommend sinakten-retard for the treatment of disseminated sclerosis.

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adolescent; Adrenal Cortex; Adrenocorticotropic Hormone; Adult; Cosyntropin; Delayed-Action Preparations; Emotions; Female; Humans; Male; Middle Aged; Multiple Sclerosis; Muscle Spasticity; Muscle Tonus; Remission, Spontaneous

Topics: Adult; Azathioprine; Cholinesterase Inhibitors; Cosyntropin; Drug Therapy, Combination; Enzyme Inhibitors; Female; Humans; Middle Aged; Myasthenia Gravis; Prednisolone; Pyridostigmine Bromide; Remission, Spontaneous; Thymectomy

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