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CLINICAL USEFULNESS OF DETERMINATION OF CIRCULATING 17-HYDROXYCORTICOSTEROID LEVELS

GERALD T. PERKOFF, M.D.; AVERY A. SANDBERG, M.D.; DON H. NELSON, M.D.; FRANK H. TYLER, M.D.
AMA Arch Intern Med. 1954;93(1):1-8. doi:10.1001/archinte.1954.00240250011001.
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THE NUMEROUS clinical and laboratory techniques that have been devised to study the functional activity of the various endocrine glands give ample testimony to the difficulty of critically evaluating endocrine function. For the estimation of the adequacy of adrenal function various metabolic processes related to effects of adrenal steroids may be studied. Some of these are the ability to excrete a water load, determinations of serum electrolytes, and observation of the blood sugar during fasting. Urinary 17-ketosteroids are in part derived from adrenal secretions but show a relatively poor correlation with adrenal function.1 Techniques are also available for the measurement of the urinary excretory products of the 17,21-dihydroxy-20-ketone steroids, but problems related to the relative proportions degraded and excreted unchanged present themselves in the evaluation of such data.1 Salt deprivation and insulin tolerance tests lack specificity and are laborious and potentially dangerous. The eosinophile response to adrenocorticotropin (ACTH) has been extremely useful

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