Thromboembolic Complications Associated With Acth and Cortisone Therapy

An increased coagulability of the blood has been noted in the hyperadrenal state induced by the therapeutic administration of corticotropin (ACTH) and cortisone. This state of hypercoagulability may persist for as long as three weeks after cessation of therapy with these agents.¹When these coagulation changes were reported in 1950, reference was made to 11 instances of thromboembolism which had been observed in association with the use of corticotropin or cortisone.¹Smith and others²have also observed alterations of the coagulation mechanism during hormonal therapy. In addition, thrombotic phenomena, noted clinically or at autopsy, have been remarked on by Schick and his associates,³by Sharnoff and others,⁴by Bongiovanni and Eisenmenger,⁵and by Coste and his co-workers.⁶ Over the period of the last two years it is estimated that approximately 700 patients have received corticotropin or cortisone therapy at Presbyterian Hospital. Among this