INTERMITTENT treatment with adrenocorticotropic hormone, first described by Farnsworth,1 is a definite milestone in the management of the nephrotic syndrome. Diuresis is accomplished in 45 to 80% of the cases,* and in many improvement is maintained. Those who require repeated courses, however, swing from an edematous state to a dehydrated, washed-out, debilitated condition and are rarely well enough to live normal lives. They eat voraciously at times and are anorectic at others.
In the summer of 1951, when a 3-year-old child failed to have her usual diuretic response following a 12-day course of corticotropin (ACTH) treatment was resumed at a lower dosage level for two more weeks, after which complete diuresis occurred. The child (L. H.) had had a series of 10 courses by March 3, 1952. Between courses albuminuria would disappear, only to reappear in a few days followed by edema. She was never well enough to permit
MERRILL AJ, WILSON J, TIMBERLAKE LF. CONTINUOUS THERAPY OF NEPHROTIC SYNDROME IN CHILDREN WITH CORTICOTROPIN GEL. AMA Arch Intern Med. 1954;94(6):925–930. doi:10.1001/archinte.1954.00250060059005
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