CLINICAL USE OF FLUDROCORTISONE ACETATE

Halogenation of cortisone and hydrocortisone in the 9-α position has been shown1to alter the effects of these compounds both qualitatively and quantitatively. Fludrocortisone acetate (9-α-fluorohydrocortisone) was shown to have a cortisone-like effect in adrenalectomized dogs averaging approximately 20 times as great, milligram for milligram, as hydrocortisone. It was also shown to have an effect on mineral metabolism similar to desoxycorticosterone (Doca) acetate but averaging five times as great as desoxycorticosterone. In order to evaluate the effect of this medication we have administered fludrocortisone acetate to several patients with diseases that have been found amenable to adrenal steroid therapy. REPORT OF CASES Case 1.— The first case in which this medicament was used was that of a 40-year-old woman with anorexia nervosa whose weight had gradually decreased to 84 lb. (38.6 kg.) and who had not responded to other therapy. She received 2 mg. of fludrocortisone acetate daily for