Isolated corticotrophin deficiency

Andrioli, Massimiliano; Giraldi, Francesca Pecori; Cavagnini, Francesco

doi:10.1007/s11102-006-0408-5

Cited by 128 publications

(123 citation statements)

References 73 publications

Supporting

Mentioning

116

Contrasting

Unclassified

Order By: Relevance

“…The majority of acquired IAD cases are thought to result from an autoimmune mechanism, as suggested by the presence of anti-pituitary antibodies in some patients with IAD, cases with lymphocytic hypophysitis that are complicated with IAD, and the frequent association of IAD and other autoimmune endocrine disorders [1][2][3]. Although the present patient had several autoantibodies, anti-pituitary antibodies were not detected.…”

Section: Discussionmentioning

confidence: 79%

“…Although isolated adrenocorticotropin (ACTH) deficiency (IAD) is a heterogeneous disorder with several etiologies, the majority of acquired cases are most likely due to an autoimmune process [1][2][3]. Painless thyroiditis, which is considered a variant form of Hashimoto's thyroiditis, is characterized by transient thyrotoxicosis that is sometimes followed by transient hypothyroidism and then recovery [4].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Isolated Adrenocorticotropin Deficiency Associated with Painless Thyroiditis: A Case Report and Review of the Literature

et al. 2012

View full text Add to dashboard Cite

INTRODUCTIONAlthough isolated adrenocorticotropin (ACTH) deficiency (IAD) is a heterogeneous disorder with several etiologies, the majority of acquired cases are most likely due to an autoimmune process [1][2][3]. Painless thyroiditis, which is considered a variant form of Hashimoto's thyroiditis, is characterized by transient thyrotoxicosis that is sometimes followed by transient hypothyroidism and then recovery [4]. Although acquired IAD is not uncommonly associated with other autoimmune endocrine disorders, especially Hashimoto's thyroiditis [5,6], reported cases of IAD associated with painless thyroiditis are scarce. Herein, we report a case of IAD associated with painless thyroiditis and briefly review the literature. CASE REPORTA 53-year-old Japanese man was admitted to hospital with a 3-month history of transient headache followed by general fatigue, weight loss of 4 kg and myalgia. He had a history of ocular myasthenia gravis which had been in remission following thymectomy 30 years prior to admission. He had no family history of endocrine or autoimmune disorders. On admission, he was 157 cm in height and weighed 47 kg. His blood pressure was 108/68 mmHg, pulse was regular at 92 beats/min, and his temperature was 37.1℃. Ophthalmologic examinations, including visual acuity, visual field and ocular fundus revealed no abnormalities. A small diffuse goiter was palpable without tenderness. The heart, lungs and abdomen were not remarkable. The relaxation phase of the Achilles ten- Kurume Medical Journal, 59, 71-77, 2012 Summary: A 53-year-old Japanese man was admitted with a 3-month history of transient headache followed by general fatigue and weight loss. He had a history of ocular myasthenia gravis which had been in remission following thymectomy 30 years ago. He had a small diffuse goiter without tenderness, and was diagnosed as having painless thyroiditis with mild thyrotoxicosis on admission. Endocrinological studies showed he had isolated adrenocorticotropin deficiency. Magnetic resonance imaging of the pituitary gland revealed no abnormalities. His symptoms improved soon after replacement of glucocorticoid. After an episode of hypothyroidism, he spontaneously became euthyroid. It is likely that thyrotoxicosis uncovered adrenal insufficiency that had developed insidiously, and hypoadrenocorticism-induced immunological changes may have triggered the development of painless thyroiditis. Moreover, thymectomy might have facilitated the development of pituitary and thyroid autoimmunity.

show abstract

Section: Discussionmentioning

confidence: 79%

Section: Introductionmentioning

confidence: 99%

Isolated Adrenocorticotropin Deficiency Associated with Painless Thyroiditis: A Case Report and Review of the Literature

et al. 2012

View full text Add to dashboard Cite

show abstract

“…The pituitary hypothalamic structure was normal on MRI. [1,2] The patient improved with hydrocortisone therapy. The present case report represent a patient with concurrent isolated ACTH deficiency in a premature infant who developed retina of prematurity (ROP) which required laser therapy.…”

Section: Discussionmentioning

confidence: 95%

“…[1] The defect is usually at the pituitary level but can be at the hypothalamus. [2] Most cases are secondary to autoimmune process such lymphocytic hypophysitis.…”

Section: Introductionmentioning

confidence: 99%

Transient Adenocorticotropic Hormone deficiency in an infant

Jurayyan

Issa

Jurayyan

2016

CRCP

View full text Add to dashboard Cite

Background: Isolated Adenocorticotropin Hormone (ACTH) deficiency is a rare disorder, characterized by secondary adrenal insufficiency with a low or absent cortisol production, normal secretion of other pituitary hormones and absence of structural pituitary defects. Case summary: The patient was the product of a 28 weeks gestation, clomiphen induced to a 40-year-old, gestational diabetic mother. He was ventilated for 30 days, and was diagnosed to have grade IV Retina of Prematurity (ROP). He suffered from recurrent attacks of hypoglycemic, blood sugar of 1.6 mmol/L, low serum cortisol 65 nmol/L (normal; 150-630), and ACTH of 1.5 pmol/L (normal; 1.6-13.9), with suppressed serum insulin and normal thyroid, growth hormone and gonadal functions. Magnetic Resonance Imaging (MRI) was unremarkable. He was started on hydrocortisone 2.5 mg twice daily for two years, which was then slowly tapered and stopped. Later Serum cortisol was 175 nmol/L, and ACTH of 5.5 pmol/L with a normal shot ACTH stimulation test. Conclusions: This case of a premature baby who presented with recurrent hypoglycemia had an isolated ACTH deficiency that proved to be transient. The pediatricians need to be aware of the existence of such condition.

show abstract

“…1) Here we report a case of IAD associated with Hashimoto's disease in a patient who presented with thyroid crisis triggered by head trauma.…”

Section: Introductionmentioning

confidence: 92%

Isolated Adrenocorticotropic Hormone Deficiency Associated With Hashimoto's Disease and Thyroid Crisis Triggered by Head Trauma -Case Report-

Tanei

Eguchi

Yamamoto

et al. 2012

Neurol. Med. Chir.(Tokyo)

View full text Add to dashboard Cite

A 47-year-old man presented to our hospital after suffering transient loss of consciousness and falling to the floor. On admission, his Glasgow Coma Scale score was 11 (E3V3M5), and he exhibited restlessness. Blood examination revealed hyperthyroidism. Computed tomography showed slight traumatic subarachnoid hemorrhage. He developed fever and tachycardia, and was diagnosed with thyroid crisis. Magnetic resonance imaging showed a brain contusion in the right frontal lobe, and encephalopathy signs in the right frontal and insular cortex. Immunocytochemical examinations suggested Hashimoto's disease, and hormone examinations revealed plasma levels were undetectably low of adrenocorticotropic hormone (ACTH) and low of cortisol. Pituitary stimulation tests showed inadequate plasma ACTH and cortisol response, consistent with isolated ACTH deficiency (IAD). The final diagnosis was IAD associated with Hashimoto's disease. Hydrocortisone replacement therapy was continued, and the patient was nearly free from neurological deficits after 18 months. The neuroimaging abnormalities gradually improved with time.

show abstract

Isolated corticotrophin deficiency

Cited by 128 publications

References 73 publications

Isolated Adrenocorticotropin Deficiency Associated with Painless Thyroiditis: A Case Report and Review of the Literature

Isolated Adrenocorticotropin Deficiency Associated with Painless Thyroiditis: A Case Report and Review of the Literature

Transient Adenocorticotropic Hormone deficiency in an infant

Isolated Adrenocorticotropic Hormone Deficiency Associated With Hashimoto's Disease and Thyroid Crisis Triggered by Head Trauma -Case Report-

Contact Info

Product

Resources

About