Levels of glucocorticoids and adrenal androgens in remote periods after adrenalectomy

Abstract

The levels of the major exogenous glucocorticoids, hydrocortisone and corticosterone, and adrenal androgens, dehydroepiandrosterone and its sulfate, were measured in the blood plasma of patients with Cushing’s disease and syndrome 3 and 10 years after uni- or bilateral adrenalectomy. Secretion of both C21 and C19 steroids, although lower than in health, was observed in all the patients. Daily rhythm of steroid release into the blood was as a rule impaired in patients after bilateral adrenalectomy, whereas in those after unilateral adrenalectomy a normal daily time course of the tested steroid levels in the blood was observed. Functional dexamethasone test showed differences in the time course of steroid response in patients subjected to bilateral adrenalectomy vs. that in normal subjects, whereas the adrenal left after unilateral adrenalectomy reacted to dexamethasone similarly as in health. These data reliably evidence the presence of functioning “extra” tissue in patients with Cushing’s disease after bilateral adrenalectomy.