PRELIMINARY STUDIES IN PLASMA AND CEREBROSPINAL FLUID CORTISOL IN CHILDREN WITH DIFFERENT DISEASES

Abstract

Corticosteroids and ACTH can successfully be used for therapy of infantile spasms, especially when spasms are of idiopathic origin. Therefore we are interested in the amount of cerebrospinal fluid (CSF) cortisol and the ratio of plasma to CSF cortisol. Using a protein binding technique we studied plasma and CSF cortisol in 5 children with infantile spasms (West syndrome) and 48 other children, from the neonatal period up to 14 years. In the infantile spasms group we found elevated cortisol levels, in the plasma exceeding 260 ng/ml and in the CSF higher than 26 ng/ml, and CSF cortisol relatively more elevated than plasma cortisol, the ratio plasma to CSF cortisol was therefore below 10. Similar findings were observed in 15 other patients with different diseases. All the other patients showed a normal plasma cortisol level and a ratio plasma to CSF cortisol higher than 10. Our results seem to be in correlation with the experiments of Ortiz-Galvan and Morell who suggested that cortisol might have a protecting function in the central nervous system. Low suspected that cortisol might act by stimulation of enzyme activity. Karl son and Sekeris and also Kroger demonstrated the induction of enzymes by cortisol and synthetic corticoids. Therefore it may be that there exists a correlation between the disease of the central nervous system and the CSF cortisol levels. Further studies will give us more information on this matter.