Bilateral adrenal hemorrhage as a complication of intravenous ACTH infusion in two patients with inflammatory bowel disease.

We report two patients with inflammatory bowel disease in whom intravenous corticotropin therapy was complicated by bilateral adrenal hemorrhage. In one, the initial presentation was acute and unilateral, simulating colonic perforation and/or abscess. The diagnosis was made only at exploratory laparotomy. In the second patient, the presentation was subacute; multiple episodes of adrenal hemorrhage occurred subsequent to the course of corticotropin, and ultimately, hypoadrenalinism developed. Pertinent clinical and computed tomographic findings are reviewed.

The in vitro suppression of antigen- or mitogen-induced DNA synthesis by murine spleen cells after the addition of freshly prepared syngeneic cells.

The suppression of antigen- and mitogen-induced DNA synthesis by murine spleen cells in vitro was investigated. It appears that cultures receiving two signals exhibit marked suppression of DNA synthesis. The addition of KLH, PPD, Con A, PHA, or LPS to 72-hr-lod cultures of KLH-stimulated murine spleen cells resulted in the suppression of DNA synthesis assayed at 144 hr. When small numbers of freshly prepared KLH-PPD SC or NSC were added to these cultures at 72 hr the suppression of DNA synthesis was abrogated. However, the addition of larger numbers of KLH-PPD SC or NSC resulted in increased suppression of DNA synthesis. Large numbers of KLH-PPD SC or NSC could substitute for the second stimulant (KLH, PPD, Con A, PHA, or LPS) in suppressing DNA synthesis. The addition of fresh cells obtained from KLH-PPD-immunized mice were more effective in eliciting the subsequent suppression than were cells obtained from non-immunized mice. Cells obtained 30 to 75 days post immunization were most effective in suppressing DNA synthesis.