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Evidence of Persistent Abnormal Pituitary-adrenal Relationship in Patients Subtotally Adrenalectomized for Cushing's Syndrome.

W. D. Drucker, M.D.; and N. P. Christy, M.D.
Ann Intern Med. 1963;58(4):721-722. doi:10.7326/0003-4819-58-4-721_3
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Patients J. J. and D.W., bilaterally subtotally adrenalectomized for Cushing's disease (bilateral adrenal hyperplasia) 7 and 6 years before study, lacked pituitary tumors and were not hyperadrenal as shown by: clinical remission, normal excretion of urinary 17-ketogenic steroids (19 and 12 mg/day) and 17-ketosteroids (13 and 8 mg/day), normal secretory rate of cortisol (20 and 19 mg/day, isotope dilution method), and normal resting levels of plasma cortisol (13 and 11 μg/100 ml). Evidence of abnormal adenohypophysial regulation of adrenal cortical secretion included: total absence of circadian variation in levels of plasma cortisol; failure to respond by increased steroidogenesis


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