672 PANTOTHENIC ACID 



the intestinal synthesis of folic acid and biotin is affected in pantothenic acid 

 deficiency,^'* and it may be that any effects on the hematopoietic system 

 are the result of an associated deficiency of folic acid. 



(4) Pantothenic Acid Therapy in Metabolic Disease. In view of the fact 

 that an absence of pantothenic acid in animals was associated with atrophy 

 and, in many instances, necrosis and hemorrhage of the adrenal cortex, the 

 use of this vitamin in the treatment of patients with Addison's disease 

 naturally has suggested itself. The author has personally given three pa- 

 tients with Addison's disease massive doses of calcium pantothenate (10 

 to 20 g. daily). There was no evidence of any effect on the course of the 

 disease or on the hormone requirement of these patients. In two of them 

 the etiological cause of the Addison's disease was presumably tuberculosis, 

 as other evidences of tuberculosis were present in the patients. It may be 

 that the different etiological factors involved, i.e., pantothenic acid defi- 

 ciency in the rat and a chronic infection in the human being, explain the 

 fact that no clinical effect was observed. 



Disturbances of carbohydrate metabolism have been reported as associ- 

 ated ^vith pantothenic acid deficiency in many species.^^^'^^^ Gershberg et 

 alP'^ studied the ability of patients to acetylate PABA and sulfadiazine 

 after having been administered large amounts of this vitamin (from 10 to 

 20 g.). No depression of acetylation was observed in patients with liver dis- 

 ease or in patients with rheumatoid arthritis, diabetes mellitus, hypothy- 

 roidism, sprue, or leukemia. In patients with hyperthyroidism, a diminished 

 capacity to acetylate was observed, which was improved by the administra- 

 tion of sodium acetate, suggesting that in hyperthyroidism there is a de- 

 crease in available acetate due to its rapid utilization. One might infer that 

 patients with hyperthyroidism would be more susceptible to pantothenic 

 acid deficiency than normal subjects. In this respect it is interesting that 

 Drill and Overman-^^ found that the requirement for pantothenic acid in- 

 creased in experimental hyperthyroidism in rats. 



(5) Pantothenic Acid in Other Clinical Situations. Jacques^^^ reported the 

 use of pantothenic acid in the treatment of surgical patients with severe 



22^ B. N. Berg, T. F. Zucker, and L. M. Zucker, Proc. Soc. Exptl. Biol. Med. 71, 374 



(1949). 

 226 L. D. Wright, /. Biol. Chem. 142, 445 (1942). 



226 A. E. Schaefer, J. M. McKibbin, and C. A. Elvehjem, J. Biol. Chem. 143, 321 

 (1942). 



227 A. Dorfman, S. Berkman, and S. A. Koser, J. Biol. Chem. 144, 393 (1942). 



228 H. Mcllwain and D. E. Hughes, Biochem. J. 38, 187 (1944). 



229 R. E. Olson and N. O. Kaplan, /. Biol. Chem. 175, 515 (1948). 



230 H. Gershberg, S. H. Rubin, and E. P. Ralli, /. Nutrition 39, 107 (1949). 



231 V. A. Drill and R. Overman, Am. J. Physiol. 135, 474 (1942). 



232 J. E. Jacques, Lancet II, 861 (1951). 



