Abstract
Adrenocortical steroid secretion was studied in 10 infants (mean age 8.9 months, range 5-22 months) during and after ACTH therapy for infantile spasms. Long-acting ACTH (Acortan prolongR., Ferring, Sweden) was given i.m. once daily, 80 units during the first 3 weeks, 40 units during the following 2 weeks with tapering and termination within the next week. Serum dehydroepiandrosterone (DHA), androstenedione (A) and cortisol (F), and 24 h urinary cortisol (dUF) and 17-ketogenic steroids (KGS) were measured before, during (serum samples 24 h after the last ACTH dose) and after therapy (means and range nmol/1 for serum steroids, nmol for dUF and umol for KGS): Highly elevated androgen levels (up to adult values) show that ACTH is capable of causing adrenarchal changes in androgen secretion. Interestingly, after ACTH therapy there was no suppression of androgens below the pretreatment level in contrast to glucocorticoids. What causes adrenarche may not be a separate adrenal androgen stimulating hormone, but ACTH which gradually increases adrenal androgen secretion.
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