Henry Ford Hospital Medical Journal


A young woman was found to have persistent Cushing's syndrome one year after surgical removal of both hyperplastic adrenal glands. Improvement followed pituitary irradiation butshe developed skin pigmentation. Remission of the adrenal hyperfunction occurred only after several months of therapy with o,p'-DDD. Within 15 months, the recurrent disorder required a second course of DDD with resulting adrenal insufficiency. Eighteen months later, however, steroid supplements were no longer required and increasing Cortisol levels indicated still another imminent relapse. There was no enlargement of the sella turcica. The patient had received no treatment whatever for nearly nine months when she experienced a sudden severe headache associated with vomiting. Plasma Cortisol was undetectable thereafter, dermal pigment abated and menstrual periods stopped. Gonadotropin and ACTH levels were very low. The final remission is believed to have resulted from Infarction of the anterior pituitary.