[Diagnosis of adrenal cortex diseases using radioimmunoassay of hormone levels in blood samples from the inferior vena cava and its tributaries]

Abstract

To diagnose the Icenko-Cushing syndrome and disease, samples of the venous blood were taken from the inferior vena cava, the renal and adrenal veins of 51 patients to determine hydrocortisone and ACTH. Thirty-nine patients showed a tendency to an increase in the basal level of hydrocortisone in the blood from the inferior vena cava and the renal veins and a significant elevation of its concentration by approximately an equal value in the blood from both adrenal veins. The ACTH content in their blood was elevated, all these indicating the presence of primary disorders in the hypothalamus-hypophysis system and the secondary involvement of the adrenal cortex in the pathological process, i.e. the Icenko-Cushing disease. Different changes of the hydrocortisone content in some places of the venous blood sampling were observed in 12 patients. A significant difference in the hydrocortisone concentration from the left and right adrenal veins and a decrease in the ACTH level in the blood were observed. Such a combination of the signs points to the presence of an autonomous hormone producing adrenal tumor (the Icenko-Cushing syndrome). The results of measurement of the hydrocortisone concentration in the blood within a group of patients with suspicion of corticosteroma recurrence were taken into account to select an appropriate therapeutic method.