[Circadian rhythm of cortisol and corticotropin (ACTH) in patients with rheumatoid arthritis in relation to inflammatory activity].
In patients with rheumatoid arthritis, corticosteroids are usually given as a single morning dose to minimize adrenal suppression, because of the well-known circadian rhythm of the secretion of cortisol and corticotropin. However, it has not been so far examined whether there really is a normal secretion pattern of those hormones in all patients with rheumatoid arthritis, as there is in healthy subjects. We therefore studied twelve patients with rheumatoid arthritis who had never been treated before with corticosteroids and disease-modifying drugs such as gold, D-penicillamine or immunosuppressive drugs. The study was designed to examine adrenal secretory activity by measuring the cortisol and corticotropin levels at 2 h intervals throughout a 24 h cycle. The circadian secretion patterns of cortisol and corticotropin were disturbed in most patients. High inflammatory activity of the disease was accompanied by a severe disturbance of the circadian rhythm, whereas patients with low inflammatory activity showed a nearly normal secretion pattern. Besides other causes, the influence of mediators of inflammation on hypothalamic centers, analogous to endogenous pyrogen in fever, must be discussed.
D000324:Adrenocorticotropic Hormone / Q000097:blood*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000097:blood* / Q000175:diagnosis; D001799:Blood Sedimentation; D002940:Circadian Rhythm; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D008297:Male; D008875:Middle Aged
D000324:Adrenocorticotropic Hormone; D006854:Hydrocortisone
Die circadiane Rhythmik von Cortisol und Corticotropin (ACTH) bei Patienten mit rheumatoider Arthritis in Abhängigkeit von der Entzündungsaktivität.