Atrial Septal Defect with Mitral Stenosis in a Woman of 81

Four patients suffering from virilism due to adrenocortical hyperplasia were treated with cortisone, hydro- cortisone acetate, prednisone, or prednisolone for periods ranging from six to eighteen months.Oral cortisone was effective in reducing to normal the 17- ketosteroid excretion in the two younger patients, aged 31 and 16 years, but was ineffective in the two older patients, aged 19 and 20 years.Prednisone and prednisolone were the most active in depressing the 17-ketosteroid levels, prednisone being about five times more potent in this respect than oral cortisone and having from two-thirds to three-quarters of the activity of prednisolone.Hydrocortisone acetate injected intramuscularly weekly or fortnightly was also effective.Growth of excess hair was retarded to some extent; acne disappeared in three patients in whom it was present; and menstruation was established in one patient with secondary amenorrhoea.We are indebted to Ciba Laboratories Ltd. for supplies of prednisone (" ultracorten ").