Treatment of the nephrotic syndrome with corticotropin (ACTH) and cortisone; a four-and-one-half-year survey of results with short-term courses.

Abstract

The effect of corticotropin (adrenocorticotropic hormone [ACTH]) and cortisone on the acute state of the nephrotic syndrome has been described by a number of workers.* That endogenous corticotropin may be responsible for spontaneous remissions is suggested by diuresis following measles and other infections complicating the disease. Also, in one patient whom we observed during the occurrence of a spontaneous remission, we found an increase in urinary cortins and 17-ketosteroids, a fall in eosinophile count and an increase in uric acidcreatinine ratio immediately preceding the diuresis.4It is the purpose of this communication to try to evaluate the ultimate value of these hormones when given in short-term courses by reviewing our observations in 64 infants and children who had the nephrotic syndrome and who were treated with either corticotropin or cortisone during the past four and one-half years. In accordance with a recently proposed classification,5no effort will be