QUANTITATIVE ESTIMATION OF ADRENOCORTICAL HORMONES AND THEIR α-KETOLIC METABOLITES IN URINE

Abstract

ABSTRACT Urinary corticosteroid patterns were estimated in patients with adrenocortical insufficiency. In patients with secondary adrenocortical hypofunction (Panhypopituitarism) the patterns reflect an abnormally low secretion of cortisol, corticosterone and Reichstein's S. The ratios between these corticosteroids are not altered. Aldosterone secretion can be temporarily normal or even increased. The THF/THE-ratio is elevated and this is presumably due to a diminished production of thyroid hormone. In patients with primary adrenocortical hypofunction (Addison's disease) the patterns reflect an abnormally low secretion of corticosterone and aldosterone. Initially the secretion of cortisol can be within the normal range. The secretion of Reichstein's S is often normal or even increased. The ratios between the corticosteroids are altered in that the F/B-ratio is high and the F/S-ratio low. These characteristics, presumably due to excessive adrenocortical stimulation by endogenous ACTH, can be helpful in differentiating the two kinds of adrenocortical insufficiency and in diagnosing Addison's disease when the excretion of cortisol and its metabolites is still within the normal range.