The inhibitory effect of triamcinolone on adrenal function

Aldosterone deficiency in a patient with idiopathic haemochromatosis

Postural hypotension due to low aldosterone secretion was the presenting feature of idiopathic haemochromatosis in a 35-year-old man. Repeated venesection is beneficial in this disease but it is suggested that aldosterone deficiency be excluded before treatment to avoid depletion of circulating volume.

Long term results of radical hypophysectomy for Cushing's disease

Sixteen consecutive cases of Cushing's disease were treated by radical transphenoidal hypophysectomy. Surgical removal was not possible in two cases. Of the other 14, there was total clinical and biochemical remission of the disease in 13 and partial remission in one. Some form of replacement therapy has been necessary in 11 out of the 14 cases. During a long period of postoperative clinical and biochemical assessment extending over 5-14 years (average 8 years) there have been no recurrences.

Evaluation of systemic absorption of intraturbinally injected triamcinolone

As measured by depression of plasma cortisol following intranasal injection of 40 mg triamcinolone acetonide, slight systemic absorption was evident after three days in approximately 60% of patients studied. However, cortisol values were not lowered below normal limits at any time. No adrenal suppression was apparent after repeated injections. Comparison is made with the effect on plasma cortisol of triamcinolone administered by intramuscular or intra-articular injection.

Assessment of long-acting synthetic corticotrophin in hypersensitive asthmatics and normal subjects

The synthetic polypeptide depot-tetracosactrin (Synacthen-Depot) was given to nine steroid-treated asthmatic patients hypersensitive to animal corticotrophin. Eight had a satisfactory increase in plasma and urinary 17-hydroxycorticosteroids (17-OHCS). The remaining patient had been shown previously to have adrenal suppression. None of the patients developed allergic reactions to depot-tetracosactrin, and seven have been receiving regular injections of the polypeptide twice weekly for the past eight months.In 13 normal subjects intramuscular injections of 1 mg. and 0.5 mg. of depot-tetracosactrin and 40 units of corticotrophin-gel were equally potent in raising the plasma 17-OHCS, but depot-tetracosactrin had a significantly longer action than corticotrophin-gel.