Hydrocortisone production in lepromatous patients with insulin load.

Hydrocortisone production was studied in 36 patients with lepromatous leprosy before and after insulin load as a stress factor using a competitive radioassay. Twenty-three patients showed a so-called paradoxical type of hydrocortisone production suggestive of markedly exhausted hydrocortisone-producing function of the adrenal cortex. Reserve hydrocortisone production was depressed in most of the patients with active disease; while cured patients showed a partial restoration in reserve hydrocortisone production. Leprosy relapses seem to be among the factors affecting the reserve hydrocortisone-producing function of adrenals. The question of reassessment of the principles of steroid therapy in lepromatous patients with relapses is raised.