Effect of exogenous glucocorticoids given during the terminal stages on the adrenocortical histology

The adrenal histology of 107 adult autopsy cases hospitalized within 8 days before death was examined. Thirteen (21.7%) of 60 cases given glucocorticoids within 24 hr of death showed the zona reticularis and lower zona fasciculata composed of clear type cells, while only two (4.2%) of the remaining 47 cases without corticoid administration showed the same histology. The difference was significant (p < 0.05), and it was referred to the exogenous corticoids. Administration of adrenalin and/or noradrenalin did not significantly influence the adrenocortical histology. The effect of the corticoids depended partly on the diseases from which the patients suffered: the effect was not observed in cases of severe infection or myocardial infarction, but it was shown in cases of cerebral apoplexy and miscellaneous diseases. The above results, on the basis of clear/compact cell morphology, suggest that exogenous glucocorticoids occasionally suppress the pituitary release of ACTH under the stress of dying.