Response of the Serum Hyaluronidase Inhibitor and Mucoproteins to Adrenocorticotropic Hormone in Rheumatic States

ACTH was administered to 13 patients with acute rheumatic fever and to two with rheumatoid arthritis. The following observations were made: [See Chart 6 in Source Pdf] 1. The elevated nonspecific hyaluronidase inhibitor concentration of the serum dropped rapidly, usually to normal values, within 10 to 15 days, and subsequently the values became subnormal. This seemed to follow closely the subjective improvement in the patient's condition. 2. The elevated serum mucoprotein concentrations slowly returned to normal over a period of 3 to 4 months. 3. In instances in which the ACTH was withdrawn, or in which the dosage was reduced before a substantial drop of the mucoprotein level had taken place, the disease recurred. 4. ACTH administered to a patient with combined diabetes mellitus and rheumatic fever effected an increase in the insulin requirement to approximately double that of the pre-ACTH period. As the ACTH was gradually withdrawn, the insulin need returned to the pre-ACTH amount. The effect of ACTH on this patient's rheumatic fever was similar to the others receiving the hormone.