Rapid appearance of transient secondary adrenocortical insufficiency after alpha-particle radiation therapy for Cushing's disease

Journal Article · Sun Aug 01 04:00:00 EDT 1976 · J. Clin. Endocrinol. Metab.; (United States)

DOI:https://doi.org/10.1210/jcem-43-2-295· OSTI ID:7354753

Cook, D M; Jordan, R M; Kendall, J W; Linfoot, J A

A 17-year-old woman received 12,000 rads of alpha-particle radiation for the treatment of Cushing's disease. One day after the completion of therapy, the patient developed nausea, vomiting, headache, and postural hypotension. Laboratory evaluation demonstrated a marked fall of the previously elevated urinary 17-hydroxycorticosteroids (17-OHCS) and undetectable plasma cortisols. The urinary 17-OHCS transiently returned to supranormal levels but over a 2/sup 1///sub 2/-week period decreased and then remained low. The patient also demonstrated a subnormal urinary aldosterone excretion in relation to plasma renin activity (PRA) during 10 mEq/24 h sodium restriction. The remainder of the endocrine evaluation was normal, suggesting that pituitary function otherwise remained intact. One and one-half years after alpha-particle therapy, the patient's urinary 17-OHCS were normal and responded normally to metyrapone. The relationship between urinary aldosterone excretion and PRA also was normal. It is postulated that there was an infarction of an ACTH secreting pituitary tumor leaving the remainder of the pituitary intact. A chronically elevated circulating level of ACTH with sudden loss of ACTH secretion appeared to have been responsible for the initial low urinary aldosterone as well as the low urinary 17-OHCS. This is the first reported case of a presumed pituitary tumor infarction in association with alpha-particle pituitary radiation.

• Research Organization: Portland Veterans Administration Hospital, OR
• OSTI ID: 7354753
• Journal Information: J. Clin. Endocrinol. Metab.; (United States), Journal Name: J. Clin. Endocrinol. Metab.; (United States) Vol. 43:2; ISSN JCEMA
• Country of Publication: United States
• Language: English

Related Subjects

560151* -- Radiation Effects on Animals-- Man
63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT.
ADRENAL GLANDS
ADRENAL HORMONES
ALDEHYDES
ALDOSTERONE
ALPHA PARTICLES
BIOLOGICAL EFFECTS
BIOLOGICAL MATERIALS
BIOLOGICAL RADIATION EFFECTS
BIOLOGICAL WASTES
BODY
BODY FLUIDS
CHARGED PARTICLES
CORTICOSTEROIDS
CUSHING SYNDROME
DISEASES
ENDOCRINE DISEASES
ENDOCRINE GLANDS
GLANDS
HORMONES
HYDROXY COMPOUNDS
KETONES
MEDICINE
MINERALOCORTICOIDS
NUCLEAR MEDICINE
ORGANIC COMPOUNDS
ORGANS
PATIENTS
PITUITARY GLAND
PREGNANES
RADIATION EFFECTS
RADIOLOGY
RADIOTHERAPY
SIDE EFFECTS
STEROID HORMONES
STEROIDS
THERAPY
URINE
WASTES