[Various mechanisms of disorders of the hypothalamo-hypophyseal-adrenal system in Cushing's syndrome].

The authors present the results of study of corticotropine and cortizol secretion under the effect of stress caused by insulin hypoglycemia, of sensitivity of the adrenal glands to the administration of exogenous synthetic corticotropine, and of the 24-hour rhythm of the corticotropine and cortizol secretion in 26 healthy persons and in 57 patients suffering from Itsenko-Cushing's disease, including 25 after a course of treatment with chloditan, an inhibitor of the adrenal cortex function. Blood corticotropine content was determined by the radioimmunological method, and of cortizol--by competitive binding. There was revealed no significant increase of corticotropine and cortizol secretion in response to insulin hypoglycemia in Itsenko-Cushing's disease, this pointing to disturbance of the hypothalamo-hypophysio-adrenal system at the hypothalamic level. No qualitative differences were found in response of the adrenal cortex to corticotropine, this indicating the absence of changes of its sensitivity to this hormone. The 24-hour rhythm of corticotropine and cortizol secretion in this disease is inverted. At the immediate periods after chloditan treatment no normalization of the response of the adrenal cortex to insulin hypoglycemia, and of the 24-hour rhythm of corticotropine and cortizol secretion, and also of the changes in the adrenal cortex sensitivity to corticotropine was seen.