Abstract
An impaired response to a 2-hr ACTH test has been reported to predict pts with MCNS who will develop frequent relapses(FR). We have evaluated basal 8AM cortisols(B)(nl >8μg/dl) and 2 hr-post ACTH stimulation cortisols(S)(nl >30μg/dl, Ref., Leisti, 1978) in 28 pts with MCNS. Results of studies performed were: Prior to steroid therapy(Rx)(B:8±3.6*;S:18±2.9); Following alternate day Rx(QOD)(B:8±3.7;S:21.5±7.3); and 1-6 mo post Rx(B:11.8±4.5;S:21± 7.5)(*mean±SD). Pts with nl responses:
There is no significant difference between Rx groups at P<.05. The control group is significantly different from all Rx groups except B-post-pred. Abnormal tests occurred in 13/14 pts with a history of FR and 5/6 infrequent R. No relationship was observed (P<.05) between length of remission (REM) and response to ACTH in 22 pts followed >1 yr.
Thus basal and stimulated cortisol levels were frequently abnormal in pts with MCNS and suggest that further studies should be done to define possible roles for adrenal cortical hyporespon-siveness in the pathogenesis of MCNS. Response to ACTH stimulation was not predictive of length of remission in our patients.
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Hansen, N., Roy, S., Stapleton, F. et al. 1504 ADRENAL RESPONSIVENESS TO ACTH IN PATIENTS(pts) WITH MINIMAL CHANGE NEPHROTIC SYNDROME(MCNS). Pediatr Res 15 (Suppl 4), 694 (1981). https://doi.org/10.1203/00006450-198104001-01527
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DOI: https://doi.org/10.1203/00006450-198104001-01527