Studies of urinary corticosteroid by a method permitting analysis of steroids poorly soluble in water. II. Insufficient adrenal function.

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A METHOD for determination of urinary corticosteroid permitting estimation of those steroids poorly soluble in water as well as those which are freely soluble in water has been described (1). The corticosteroid estimated by this method has been termed the “total corticosteroid.” At times the steroids which partition from benzene to water have also been determined. The material which partitions freely from benzene into water is called the “water soluble corticosteroid.” The material which remains in the benzene fraction is called the “corticosteroid poorly soluble in water.” The excretion of the materials by subjects with normal adrenal function has been described (1). The present report concerns the excretion of these materials by patients with adrenal insufficiency. The methods of uring collection and analysis have been previously described (1). Total corticosteroid excretion Eleven patients with adrenal insufficiency have been studied. Single or infrequent cortiscosteroid measurements were carried out on 7 of these patients. These values and pertinent clinical data are shown in Table 1. Each of these patients had the classic picture of Addison's disease with a history of weakness, weight loss, hypotension, gastro-intestinal disturbances and pigmentation. Most of the patients had been in crisis at least once. Each had low 17-ketosteroid excretion. Other diagnostic procedures such as the Robinson-Power-Kepler test, insulin tolerance and eosinophil response to epinephrine were performed in those patients in whom the slightest question of the diagnosis seemed possible. The results were positive whenever these tests were made.