Rapid appearance of transient secondary adrenocortical insufficiency after alpha-particle radiation therapy for Cushing's disease
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), Vol. 43:2
- Country of Publication:
- United States
- Language:
- English
Similar Records
Gamma camera imaging of bilateral adrenocartical hyperplasia and adrenal tumors in the dog
Does the corticoadrenal adenoma with ''pre-Cushing's syndrome'' exist
Related Subjects
ADRENAL GLANDS
BIOLOGICAL RADIATION EFFECTS
ALDOSTERONE
CORTICOSTEROIDS
CUSHING SYNDROME
RADIOTHERAPY
PITUITARY GLAND
SIDE EFFECTS
ALPHA PARTICLES
PATIENTS
URINE
ADRENAL HORMONES
ALDEHYDES
BIOLOGICAL EFFECTS
BIOLOGICAL MATERIALS
BIOLOGICAL WASTES
BODY
BODY FLUIDS
CHARGED PARTICLES
DISEASES
ENDOCRINE DISEASES
ENDOCRINE GLANDS
GLANDS
HORMONES
HYDROXY COMPOUNDS
KETONES
MEDICINE
MINERALOCORTICOIDS
NUCLEAR MEDICINE
ORGANIC COMPOUNDS
ORGANS
PREGNANES
RADIATION EFFECTS
RADIOLOGY
STEROID HORMONES
STEROIDS
THERAPY
WASTES
560151* - Radiation Effects on Animals- Man