Pituitary-adrenocortical system in patients with Shy-Drager syndrome.
We examined ACTH responses to the three main mechanisms of ACTH secretion, i.e., stress, negative feedback and circadian rhythm, in six patients with Shy-Drager syndrome and in six control subjects to determine whether or not injury to the central autonomic nervous system provokes some disturbances in ACTH secretion. The patients showed a poor cortisol response to the stress of insulin induced hypoglycemia along with a normal ACTH and urinary 17-OHCS response to metyrapone and a normal cortisol circadian rhythm. The discrepancy between the above-mentioned functional tests of ACTH secretion is rare to our knowledge. These findings suggested the existence of a glucoreceptor defect in such patients, or the possibility that the stress of insulin induced hypoglycemia stimulates ACTH secretion by way of the autonomic nervous system.
D000324:Adrenocorticotropic Hormone / Q000378:metabolism; D001342:Autonomic Nervous System Diseases / Q000503:physiopathology*; D002940:Circadian Rhythm; D005246:Feedback; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism; D007003:Hypoglycemia / Q000139:chemically induced; D008297:Male; D008797:Metyrapone; D008875:Middle Aged; D010913:Pituitary-Adrenal System / Q000503:physiopathology*; D012791:Shy-Drager Syndrome / Q000503:physiopathology*; D013312:Stress, Physiological / Q000503:physiopathology
D000324:Adrenocorticotropic Hormone; D006854:Hydrocortisone; D008797:Metyrapone