The Danger of Corticotropin in Addison's Disease

Arch Intern Med. 1961;107(3):372-374. doi:10.1001/archinte.1961.03620030060007.
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Despite the fact that Thorn and his associates1 have given several thousand infusions of corticotropin (ACTH) to patients with a great variety of disease, they observed untoward reactions in 6 patients only. Five of these had Addison's disease. Our experience is much less extensive. In our hospital from 1950 through 1958, medical residents gave corticotropin diagnostically to 17 patients suspected of having adrenocortical insufficiency. The patients did not receive 9-α-fluorohydrocortisone. Two of the 17 died under circumstances which we believe must be attributed to the use of corticotropin.

Report upon Patients  A 65-year-old man with generalized blastomycosis appeared chronically but not seriously ill. There was weakness, anorexia, nausea, slight pigmentation, and hypotension. He was given 20 units of corticotropin gel intramuscularly for 2 days. It was thought that the collection of urine had been incomplete, so the test was recommended one day later. Eight hours after the fourth dose


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