ANTERIOR-PITUITARY FUNCTION AFTER ADRENALECTOMY IN PATIENTS WITH CUSHINGS-SYNDROME

We assessed anterior pituitary function in five patients with Cushing' s syndrome before and after the removal of cortisol-secreting adrenal adenomas. Before surgery, all patients lacked response of growth hormo ne to hypoglycaemia, four had low responses of thyrotrophin to thyrotr ophin releasing hormone, three had hypogonadism and two had low prolac tin reserve. After successful removal of the adrenal adenoma, all pati ents developed postoperative hypoadrenocorticism and recovered all imp aired anterior pituitary hormones within a period of 3 months. Our res ults point to a direct inhibiting action of glucocorticoids at the pit uitary level as the explanation for the impaired anterior pituitary fu nction. Moreover, direct gonadal suppression by glucococorticoids may be an additional mechanism of hypogonadism in some patients.