Thioguanine-induced adrenocortical necrosis and its prevention by hypophysectomy in the rat. Light and electron microscopic study

Abstract

In rats, multiple injections of thioguanine produce hemorrhagic necrosis of the adrenal cortex. Electron microscopic studies and observations with the diffusion tracer horseradish peroxidase suggest that the primary lesion is at the level of capillary endothelial cells but a direct toxic action on adrenocortical cells cannot be excluded. Local intravascular platelet accumulation and aggregation as well as injury of adrenocortical cells seem to occur as a subsequent consequence of the endothelial changes induced by thioguanine. Hypophysectomy performed 7 days prior to the initiation of thioguanine treatment results in adrenocortical atrophy and complete prevention of adrenal apoplexy.