Adrenal cortical function in chronic pulmonary tuberculosis

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Summary 1. The excretion of unconjugated and conjugated 17-OHCS and formaldehydogenic corticosteroids was studied in chronic pulmonary tuberculosis. 2. A significant correlation was noted between the excretion of total corticosteroids and severity of pulmonary tuberculosis. 3. The low value of the excretion of total corticosteroids seen frequently in patients with moderately and far advanced pulmonary tuberculosis was largely due to a reduction in the conjugated fraction, while the unconjugated fraction remained at normal level. 4. Some cases with far advanced pulmonary tuberculosis showed a decrease in the value of the unconjugated fraction as well as the conjugated fraction. This indicates that patients with moderately and far advanced pulmonary tuberculosis have a form of adrenal insufficiency. 5. Following ACTH administration an increase in the excretion of unconjugated and conjugated corticosteroids was seen in these cases, suggesting secondary hypofunction of the adrenal cortex.

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