Serum Steroids and Success of Corticotropin Therapy in Infantile Spasms

ABSTRACT. Serum levels of 8 steroids and urinary Cortisol excretion were determined in 10 infants before and during corticotropin therapy for infantile spasms. High serum dehydroepiandrosterone-androstenedione concentration ratio distinguished the 6 infants with good therapeutic response from the 4 with poor response ( p =0.001). No such distinction was obtained directly by any of the serum steroid levels, 24-hour urinary Cortisol, or serum pregnenolone-proges-terone concentration ratio. This suggests that the therapeutic effect of corticotropin may be mediated by steroid factors other than Cortisol. Inhibition of the 3 β-hydroxysteroid dehydrogenase system in zona reticularis might be beneficial during the corticotropin therapy.