THE METABOLISM OF [4-14C]CORTISOL IN PATIENTS WITH COLLAGEN DISEASES

Abstract

SUMMARY The major metabolic pathways of cortisol have been studied in detail after injection of a tracer dose of [4-14C]cortisol in two patients with rheumatoid arthritis and in one with disseminated lupus erythematosus. Results are also presented from preliminary experiments in two other patients with rheumatoid arthritis. The rates of cortisol secretion by the adrenals of all the patients studied were within the normal range and the kinetics of cortisol metabolism were also normal. No abnormalities were found in either the proportions of cortisol, cortisone and 6β-hydroxycortisol in the urinary fraction containing the unconjugated steroids or in that of tetrahydrocortisol, allo-tetrahydrocortisol, tetrahydrocortisone, cortols, cortolones, 11β-hydroxyaetiocholanolone, 11β-hydroxyandrosterone and 11-oxoaetiocholanolone in the fraction released by hydrolysis of the urinary steroid conjugates. The excretion of 6β-hydroxycortisol in a group of patients with rheumatoid arthritis was not significantly greater than that in a similar group of normal subjects in whom the upper limit of the range was higher than values previously reported.