Abstract
A case is reported of a 38-yrold woman with acromegaly and virilism. Several abnormalities of adrenal function were found: moderately elevated urinary 17-ketosteroids and free cortisol, no evident diurnal variation in plasma cortisol, no reduction of urinary steroids after dexamethasone administration and excessive response to ACTH. 17-Hydroxycorticosteroid levels and the response to methopyrapone were normal. Surgical removal of a mixed pituitary adenoma resulted in clinical remission and eventual return of suppressible adrenal function. It is suggested that the tumor secreted both GH and ACTH at a fixed rate not subject to normal physiologic control. Recently published studies have demonstrated reduced cortisol secretion rate resulting from growth hormone administration in man and experimental animals. Observations in this case are compatible with the concept of altered adrenocortical function secondary to growth hormone in the presence of concomitantly increased ACTH secretion.
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More From: The Journal of clinical endocrinology and metabolism
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