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Secondary pituitary hyperplasia in Addison's disease
Lancet (London, England)
|November 5, 1977
Summary
Patients with Addison's disease show partial suppression of adrenocorticotrophic-hormone (ACTH) levels with hydrocortisone treatment. This suggests inadequate replacement therapy may contribute to pituitary hyperplasia and Nelson's syndrome.
Area of Science:
- Endocrinology
- Hormone Regulation
- Pituitary Disorders
Background:
- Addison's disease involves adrenal insufficiency.
- Elevated adrenocorticotrophic-hormone (ACTH) levels are characteristic.
- Hydrocortisone is a standard replacement therapy.
Purpose of the Study:
- To investigate the effect of hydrocortisone on ACTH levels in Addison's disease.
- To compare ACTH suppressibility with TSH regulation in myxoedema.
Main Methods:
- Administration of hydrocortisone to patients with Addison's disease.
- Monitoring of ACTH levels before and during treatment.
- Comparison with data from myxoedema patients treated with triiodothyronine.
Main Results:
- Hydrocortisone provided only partial suppression of elevated ACTH levels in treated and untreated Addison's disease patients.
- This partial suppression is comparable to the lack of thyrotropin (TSH) inhibition by triiodothyronine in untreated myxoedema.
Conclusions:
- Inadequate ACTH suppressibility in treated Addison's disease may stem from secondary pituitary hyperplasia due to insufficient hormone replacement.
- This finding has clinical implications for the development of Nelson's syndrome.