José Hernán Martínez, Michelle M Mangual Garcia, Madeleine Gutiérrez Acevedo, Alfredo Sánchez Cruz, Ivan Laboy, Carmen Rivera, Paola Mansilla, Coromoto Palermo Garofalo, María Lourdes Miranda, Oberto Torres Rafael
{"title":"一中年妇女孤立ACTH缺乏与短暂性生长激素缺乏相关。","authors":"José Hernán Martínez, Michelle M Mangual Garcia, Madeleine Gutiérrez Acevedo, Alfredo Sánchez Cruz, Ivan Laboy, Carmen Rivera, Paola Mansilla, Coromoto Palermo Garofalo, María Lourdes Miranda, Oberto Torres Rafael","doi":"","DOIUrl":null,"url":null,"abstract":"<p><p>Isolated ACTH deficiency (IAD) is a rare entity characterized by secondary\nadrenal insufficiency with low levels of serum cortisol, decreased\nproduction of ACTH, adequate secretion of other pituitary hormones\nand normal pituitary structure on radioimaging. The prevalence of\nIAD as a cause of secondary adrenal insufficiency has not been determined.\nImpairment of growth hormone (GH) secretion has been\nnoted in 20 to 30% of patients with IAD which is normalized after glucocorticoid\nreplacement. We report the case of a 50 years-old female\nwith symptoms and laboratory results suggestive of adrenal insufficiency.\nInsulin tolerance test confirmed ACTH and growth hormone\ndeficiency. The rest of the anterior pituitary hormones were normal. A\npituitary MRI was unremarkable. Glucocorticoid replacement therapy\nstarted and eight months afterwards glucagon stimulation test revealed\npersistent ACTH deficiency but nor-\nmal growth hormone secretion. IAD can present with nonspecific symptoms\nand could be potentially fatal in an acute stressful period. Prompt\nrecognition is essential to decrease morbidity and mortality.</p>","PeriodicalId":75610,"journal":{"name":"Boletin de la Asociacion Medica de Puerto Rico","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"A middle aged woman with isolated ACTH deficiency associated with transient growth hormone deficiency.\",\"authors\":\"José Hernán Martínez, Michelle M Mangual Garcia, Madeleine Gutiérrez Acevedo, Alfredo Sánchez Cruz, Ivan Laboy, Carmen Rivera, Paola Mansilla, Coromoto Palermo Garofalo, María Lourdes Miranda, Oberto Torres Rafael\",\"doi\":\"\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Isolated ACTH deficiency (IAD) is a rare entity characterized by secondary\\nadrenal insufficiency with low levels of serum cortisol, decreased\\nproduction of ACTH, adequate secretion of other pituitary hormones\\nand normal pituitary structure on radioimaging. The prevalence of\\nIAD as a cause of secondary adrenal insufficiency has not been determined.\\nImpairment of growth hormone (GH) secretion has been\\nnoted in 20 to 30% of patients with IAD which is normalized after glucocorticoid\\nreplacement. We report the case of a 50 years-old female\\nwith symptoms and laboratory results suggestive of adrenal insufficiency.\\nInsulin tolerance test confirmed ACTH and growth hormone\\ndeficiency. The rest of the anterior pituitary hormones were normal. A\\npituitary MRI was unremarkable. Glucocorticoid replacement therapy\\nstarted and eight months afterwards glucagon stimulation test revealed\\npersistent ACTH deficiency but nor-\\nmal growth hormone secretion. IAD can present with nonspecific symptoms\\nand could be potentially fatal in an acute stressful period. Prompt\\nrecognition is essential to decrease morbidity and mortality.</p>\",\"PeriodicalId\":75610,\"journal\":{\"name\":\"Boletin de la Asociacion Medica de Puerto Rico\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2016-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Boletin de la Asociacion Medica de Puerto Rico\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Boletin de la Asociacion Medica de Puerto Rico","FirstCategoryId":"1085","ListUrlMain":"","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
A middle aged woman with isolated ACTH deficiency associated with transient growth hormone deficiency.
Isolated ACTH deficiency (IAD) is a rare entity characterized by secondary
adrenal insufficiency with low levels of serum cortisol, decreased
production of ACTH, adequate secretion of other pituitary hormones
and normal pituitary structure on radioimaging. The prevalence of
IAD as a cause of secondary adrenal insufficiency has not been determined.
Impairment of growth hormone (GH) secretion has been
noted in 20 to 30% of patients with IAD which is normalized after glucocorticoid
replacement. We report the case of a 50 years-old female
with symptoms and laboratory results suggestive of adrenal insufficiency.
Insulin tolerance test confirmed ACTH and growth hormone
deficiency. The rest of the anterior pituitary hormones were normal. A
pituitary MRI was unremarkable. Glucocorticoid replacement therapy
started and eight months afterwards glucagon stimulation test revealed
persistent ACTH deficiency but nor-
mal growth hormone secretion. IAD can present with nonspecific symptoms
and could be potentially fatal in an acute stressful period. Prompt
recognition is essential to decrease morbidity and mortality.