ALAN WASSERSTEIN, M.D.
To the editor: Peripheral edema may be a prominent feature of the ectopic adrenocorticotropic hormone (ACTH) syndrome, and has been attributed to mineralocorticoid excess (1,2). However, in other cases of mineralocorticoid excess, such as primary aldosteronism, escape from the salt-retaining effects of mineralocorticoids prevents the formation of edema. Escape from these effects has also been shown after constant daily exogenous ACTH infusion (3). The mechanism of the failure of sodium escape in the ectopic ACTH syndrome is uncertain. Conceivably, some factors associated with underlying malignancy, such as protein-calorie malnutrition or profound potassium depletion, could favor salt retention and prevent escape.
WASSERSTEIN A. Edema in the Ectopic ACTH Syndrome. Ann Intern Med. ;96:785–786. doi: 10.7326/0003-4819-96-6-785_2
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Published: Ann Intern Med. 1982;96(6_part_1):785-786.
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