PEDIATRICS Vol. 4 No. 5 November 1949, pp. 579-585
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IMMUNOLOGIC AND BIOCHEMICAL STUDIES IN INFANTS AND CHILDREN WITH SPECIAL REFERENCE TO RHEUMATIC FEVER

VIII. Response to Pituitary Adrenocorticotropic Hormone (ACTH)

KATHARINE HAIN M.D.1 and MAY G. WILSON M.D.1

1 The New York Hospital and the Department of Pediatrics, Cornell University Medical College, New York, N.Y.

A single dose of 25 mg. ACTH administered intramuscularly to 23 children, including 9 nonrheumatic and 14 rheumatic children ranging in age from 6 to 1 3 years, was well tolerated. There was no significant difference in hematologic response in the groups studied. The uric acid/creatinine ratio was slightly higher in the rheumatic group.

The hematologic response four hours after ACTH was characterized by a sharp fall of circulating eosinophils ranging from -39 to -100%. The total rise in neutrophils ranged from +5 to +67%. The differential smear showed a drop in lymphocytes from -19 to -55%.

The uric acid/creatinine ratio following ACTH ranged from -13 to +105%.,

The hematologic response to varied types of stress in eight children, including the response four hours after fasting, emotional stress, tonsillectomy and insulin, revealed a drop in circulating esoinophils from -27 to -100% and a rise in leukocytes from 6,000 to 25,000 above prestress level.

The adrenocortical reserve as determined by the response to ACTH was found to be within normal limits in the majority of rheumatic patients in this study.

Submitted on July 5, 1949