Corticosteroids in Rheumatoid Arthritis

The exact relationships between the secretory activity of the anterior pituitary-adrenal cortical system and the rheumatic disease states in man have not been completely delineated. Previous studies1have shown that while the daily urinary excretion of 17-ketosteroids in patients with rheumatoid arthritis did not differ from that seen in normal subjects, the excretion of urinary 17-hydroxycorticosteroids was slightly diminished from the mean level observed in normal subjects, due to a lower output during the early morning hours. Although these mean urinary steroid values in patients with rheumatoid arthritis differed slightly from those found in normal subjects, they were not significantly different from those seen in patients with nonrheumatic chronic illnesses. It has also been shown2,3that glucocorticoid and mineralocorticoid hormones exert distinctly different effects on connective tissue; indeed the observed effects of these hormones on inflamed tissues may be opposite. A possible relationship between these two groups of