FACTITIOUS HYPERCORTISOLURIA

A case of factitious hypercortisoluria due to the presumed addition of glucocorticoid to the urine collections is presented. The discrepancy between urine and blood steroid hormone levels first suggested that t he patient had tampered with the urine collections. Plasma steroid hor mone levels were normal, whereas the urinary free cortisol level fluct uated in a totally random fashion Urinary 17-hydroxycortico-steroid an d urinary free corticosterone levels were normal. partition chromatogr aphy of the urine indicated that the cortisol immunoactivity; coeluted with authentic cortisol. This study illustrates the value of multiple urinary and plasma steroid determinations, especially urinary or plas ma corticosterone measurements, in suspected cases of factitious Gushi ng's syndrome.