[Excretion of glucocorticoids and their metabolism in duodenal ulcer].
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In patients with thyrotoxicosis combined with primary affection of the central nervous system (CNS)-encephalitis, diencephalitis-there was revealed, like in common thyrotoxicosis, an increased production by the adrenal cortex of hydrocortisone, its intensified transformation and inactivation, reduced production of 17-ketosteroid chiefly due to the fall of dehydroepiandrosterone content, an increased urinary excretion of adrenaline and a decreased-of noradrenaline. The use of functional test with the ACTH administration demonstrated organic affection of the CNS to sharply aggravate the weakening and even the exhaustion of the functional reserves of the glomerular and the reticular zones of the adrenal cortex developing during thyrotoxicosis, and also the reserve possibilities of the sympathico-adrenal system. Direction of the changes in the 24-hour excretion of 17-OCS and corticosteriods was the same in the majority of cases. The latter can point to the presence of functional association between the hypothalamus-hypophysis-adrenal cortex systems and adrenergic regulation in these patients.
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A third case of a testosterone-secreting adrenal adenoma is presented. It differs from the other 2 cases in additionally having glucocorticoid abnormalities. Clinically, the patient had been considered as having polycystic ovaries and did show some improvement with estrogen therapy. In fact, were it not for enlarging uterine leiomyomata on this therapy which prompted a more in depth investigation to look for alternative therapy, this potentially malignant adrenal lesion may never have been discovered.