Desoxy-Corticosterone Acetate in Addison’s Disease with Presentation of a Typical Case

Abstract

Recent major advances in the management of adrenal cortical insufficiency include the use of cortical extracts^1,2,3, the use of added sodium chloride⁴ and a low potassium die⁵. Patients have been maintained in a reasonable degree of comfort with moderate activity for a number of years on such a program. The expense of the naturally derived cortical extract has been a matter of some concern, however.

Desoxy-corticosterone acetate*, produced by Steiger and Reichstein⁶ and announced in 1937, is one of several synthetic adrenal cortical hormones, and is apparently identical with Kendall’s substance B⁷. Reichstein and von Euw⁸ have more recently demonstrated its presence in beef adrenals. Reports on its clinical application have been published by a number of investigators, including Levy-Simpson^9,10, Cleghorn et al¹¹, Thorn, Howard and Emerson¹², Wilkinson, Himsworth and Jones¹⁰, Ferrebee, et al¹³. Chemically, it is closely related to pro-gesterone¹⁴.

We have treated six cases of Addison’s disease with desoxy-corti-costerone acetate for periods of six months to ten months. Dosage during various intervals of therapy has varied from 5 mgm. to as much as 20 mgm. daily. Added sodium chloride, 3 to 16 gm. per day as enteric-coated tablets, has been maintained in all cases, except during brief periods of observation. Potassium intake at first was limited in each case, but more recently severe dietary restrictions have been discontinued. Cortical extract in the form of eschatin**was given in four cases prior to initiating desoxy-corticosterone therapy.

Definite benefit was noted clinically in all cases. In two, complete symptomatic