Adrenal Failure of Pituitary Origin Plasma Protein Studies (Tiselius)

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In cases of pituitary deficiency in which lack of somatic and skeletal growth is outstanding, it has been customary to speak of pituitary dwarfism or pituitary infantilism despite the obvious coexistence of gonadal deficiency. In the same sense we speak of pituitary myxedema.

By speaking of adrenal failure of pituitary origin we purposely call attention to the fact that many of the serious symptoms of pituitary disease are of adrenal origin and that a great deal can be accomplished by treating the adrenal failure as it is treated in Addison's disease. For some years, we have used adrenal extract in such cases. More recently, the chief therapeutic agents have been desoxycorticosterone acetate the NaCl; adrenal extract, testosterone propionate or methyl testosterone have been added in some cases, and occasionally small doses of thyroid.

The 4 cases reported here are instances of rather severe pituitary failure. We purposely are not calling these cases Simmond's disease because the term suggests the type of acute pituitary damage which was the basis of the condition in Simmond's original cases and emphasizes the feature of emaciation which was not present here. Williams and Wittenberger1 reported similar cases which they classified as Simmond's disease and treated in much the same way as we have treated ours. Our cases are similar to the type which Albright2 designated panhypopituitarism, in which he emphasized the pecularities of the glucose and insulin tolerance tests.

The selected cases demonstrate some of the interesting diagnostic features and present methods of treatment. In. . .



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