All issues > Volume 29(6); 1986

Original Article

J Korean Pediatr Soc. 1986;29(6):644-652. Published online June 30, 1986.

Plasma Basal Cortisol Level and Its Significance in Minimal Change Neprotic syndrom.

Han Wook Yoo¹

¹Department of Pediatrics, Seoul National University College of Medicine

Abstract

Morning plasma basal cortisol levels were measured by radioimmunoassay in seventeen patients with minimal change nephrotic syndrome which was proved in fourteen patients pathologically and suggested clinically in three. These patients could be grouped as ten frequent relapsers and seven control group patients who consisted of five infrequent relapsers, one continuing nonresponder and one late responder according to response to steroid therapy and mode of relapse. Comparison of plasma basal cortisol level between frequent relapsers and control group patients revealed significantly lower level in frequent relapsers than control group patients (3.51±2.83ug%, 8.69±4.71ug% respectively). But differences in serum albumin level, steroid therapy duration between both groups were not significant except in age, which was younger in frequent relapsers. The patients with lower plasma basal cortisol level had a tendency to relapse more readily, especially, within three months after remission. We also described five frequent relapsers and one infrequent relapser who had faced with, hypovolemic crises, which were characterized by gasterointestinal symptoms such as severe abdominal pain, nausea, thready weak peripheral pulsation, tachycardia, moist palm and sole, hemoconcentration and abnormally lower plasma basal cortisol levels. Plasma basal cortisol levels in frequent relapsers with hypovolemic crises seemed to be much lower than in those without hypovolemic crises(2.35±2.45ug%, 4.66±3.49ug% respectively), though difference was not significant statistically because of the small number of patients. Conclusively, it is suggested that low plasma basal cortisol levels are predictably present in frequent relapsers.

Keywords :Basal cortisol; Frequent relapser; Hypovolemic crisis