Divergence in adrenal steroid secretory pattern after thermal injury in adult patients.

The influence of thermal injury on adrenal secretion of dehydroepiandrosteron sulfate (DS) and cortisol was investigated in 19 adult patients. We found that within the first 5 days after burn trauma serum levels of DS were reduced to about one third the concentration in 21 similarly aged, nonstressed adults; serum cortisol levels in burned subjects were increased twofold over control levels. Serum DS levels were progressively lower, whereas serum cortisol concentrations remained relatively constant in burned patients between 6 and 55 days postburn. These data demonstrate prolonged alterations in adrenal steroid production after thermal injury and are suggestive that adrenal androgen production is, at least in traumatized subjects, regulated by factors other than ACTH.