Positive iodine-131 6 beta-iodomethyl-19-norcholesterol (NP-59) adrenal images can precede return of adrenocortical function after o,p' DDD treatment.

Abstract

A patient with bilateral adrenal hyperplasia, due to the ectopic adrenocorticotrophic hormone (ACTH) syndrome, received a 3-month course of treatment with 1,1 dichloro-2(o-chlorophenyl)-2-(p-chlorophenyl)ethane (o,p' DDD), which caused adrenal hypofunction requiring steroid therapy. Eleven months later, Cushing's syndrome recurred. His CT scan showed a left adrenal gland that was enlarged and a normal-sized right adrenal gland. However, the NP-59 image showed increased uptake by both glands. Venous effluent was sampled from each adrenal vein. The plasma cortisol level from the left gland was 1392 ng/ml, and that from the right gland was 667 ng/ml. The latter value was not significantly different from the values obtained at peripheral sites (517-744 ng/ml). In the course of recovery from o,p' DDD damage, the ability of the adrenal gland to take up NP-59 may be restored before the return of its biosynthetic and secretory functions. Serial NP-59 adrenal images can anticipate the recurrence of Cushing's syndrome after adrenolytic therapy, thereby permitting early retreatment.

• Authors: M Sparagana, L Ackerman
• Journal: Clinical nuclear medicine (Clin Nucl Med) Vol. 13 Issue 5 Pg. 348-51 (May 1988) ISSN: 0363-9762 [Print] United States
• PMID: 3390980 (Publication Type: Case Reports, Journal Article)

Chemical References

• Iodine Radioisotopes
• 19-Iodocholesterol
• 6-iodomethylcholesterol
• Mitotane
• Cholesterol

Topics

• 19-Iodocholesterol (analogs & derivatives)
• ACTH Syndrome, Ectopic (drug therapy)
• Adrenal Glands (diagnostic imaging, drug effects, physiopathology)
• Adult
• Cholesterol (analogs & derivatives)
• Humans
• Iodine Radioisotopes
• Male
• Mitotane (adverse effects, therapeutic use)
• Paraneoplastic Endocrine Syndromes (drug therapy)
• Radionuclide Imaging
• Recurrence