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Corticotropin (ACTH) and Adrenal Steroids in Liver Disease:  A Critical Review

MOSHE B. GOLDGRABER, M.D.; JOSEPH B. KIRSNER, M.D.
AMA Arch Intern Med. 1959;104(3):469-489. doi:10.1001/archinte.1959.00270090123018.
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Introduction  Corticotropin (ACTH) and adrenal steroids in recent years have gained a prominent place in the therapeutic armamentarium of human disease. While their biologic and pharmacological actions have been studied extensively, these compounds often are prescribed, without apparently sound scientific basis, because of the absence of more effective measures, in severe life-threatening diseases. In the course of other studies, it appeared useful to review the readily available medical literature and to evaluate the usefulness and the limitations of these drugs in hepatic disease.Corticotropin and adrenal steroids have variable physiological and pharmacological effects in different species of animals. According to Long,1 mice, rats, and rabbits are cortisone-sensitive, while guinea pigs, monkeys, and men are cortisone-resistant. The effects of these substances also vary according to the dosage. A "moderate" therapeutic dose of adrenal steroids may exercise beneficial physiological effects, while large doses may be harmful. Basically, steroids are anabolic,2

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