The major metabolic pathways of cortisol in a patient with sarcoidosis have been studied after intravenous injection of a tracer dose of [4-14C]cortisol. Results from some preliminary experiments in four other patients are also presented. The effects of large doses of cortisol on its metabolism were also studied.
In all the patients studied the adrenal secretion rate of cortisol was in the low normal range. The rate of disappearance of radioactivity from the plasma fractions containing the unconjugated steroids was normal before cortisol therapy but slower than normal during therapy. During therapy there was a significant decrease in the total urinary radioactivity.
In the one patient in whom detailed studies were made, an unusually large proportion of the urinary metabolites was in the unconjugated fraction in which the amount of 6β-hydroxycortisol was greater than normal. Apart from an increased ratio of 11β-hydroxy- to their corresponding 11-oxo-metabolites there was no essential difference in the pattern of excretion of the metabolites in this patient during therapy. In this patient only 65% of the injected radioactivity was excreted in urine after 48 hr., whereas the other patients excreted a normal percentage of the injected radioactivity during this period.
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Online ISSN: 1479-6805
Print ISSN: 0022-0795
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