ISOLATED ADRENOCORTICOTROPIC HORMONE (ACTH) DEFICIENCY

1982 ◽  
Vol 32 (6) ◽  
pp. 1111-1120
Author(s):  
Kenji Matsuo ◽  
Kazuto Shigematsu ◽  
Hiroyuki Kusano ◽  
Masataka Kihara ◽  
Kioko Kawai ◽  
...  
Keyword(s):  
Adrenocorticotropic Hormone ◽  
Acth Deficiency

scholarly journals Pembrolizumab-Induced Hypophysitis With Isolated Adrenocorticotropic Hormone (ACTH) Deficiency: A Rare Immune-Mediated Adverse Event

Cureus ◽  
2021 ◽  
Author(s):  
Andrew V Doodnauth ◽  
Miriam Klar ◽  
Yohannes S Mulatu ◽  
Zohra R Malik ◽  
Krunal H Patel ◽  
...  
Keyword(s):  
Adverse Event ◽  
Adrenocorticotropic Hormone ◽  
Acth Deficiency ◽  
Immune Mediated

scholarly journals Thyroid Dysfunction in isolated Adrenocorticotropic Hormone (ACTH) Deficiency: Case Report and Literature Review.

1993 ◽  
Vol 40 (4) ◽  
pp. 473-478 ◽  
Author(s):  
TAKEHIKO MURAKAMI ◽  
SEIKI WADA ◽  
YASUYUKI KATAYAMA ◽  
YOKO NEMOTO ◽  
NOBUO KUGAI ◽  
...  
Keyword(s):  
Case Report ◽  
Literature Review ◽  
Adrenocorticotropic Hormone ◽  
Thyroid Dysfunction ◽  
Acth Deficiency

scholarly journals Isolated Adrenocorticotropin Deficiency Associated with Delirium and Takotsubo Cardiomyopathy

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Masanori Murakami ◽  
Noriko Matsushita ◽  
Rie Arai ◽  
Naohiro Takahashi ◽  
Ryuki Kawamura ◽  
...  
Keyword(s):  
Adrenal Insufficiency ◽  
Replacement Therapy ◽  
Takotsubo Cardiomyopathy ◽  
Mental State ◽  
Adrenocorticotropic Hormone ◽  
Myocardial Dysfunction ◽  
Laboratory Data ◽  
Adrenal Crisis ◽  
Isolated Acth Deficiency ◽  
Acth Deficiency

We report a 65-year-old woman with isolated adrenocorticotropic hormone (ACTH) deficiency. The patient was transported to the emergency outpatient department by ambulance complaining of malaise and nausea. Because her laboratory data revealed hyponatremia, we performed endocrinological examinations and diagnosed isolated ACTH deficiency. After admission, she went into a delirious state and suffered from takotsubo cardiomyopathy due to adrenal insufficiency. Replacement therapy with hydrocortisone sufficiently improved her delirium and cardiomyopathy. We conclude that her unstable mental state and myocardial dysfunction were closely related to adrenal insufficiency and suggest that adrenal crisis may cause delirium and Takotsubo cardiomyopathy.

scholarly journals MON-243 Atypical Presentation of Isolated Adrenocorticotropic Hormone Deficiency and Sheehan’s Syndrome

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Zahira Marie Lugo López ◽  
Nadyeschka Angelique Rivera Santana ◽  
Andrea del Toro Diez ◽  
Michelle Marie Mangual Garcia ◽  
Ernesto Sola Sanchez ◽  
...  
Keyword(s):  
Postpartum Hemorrhage ◽  
Adrenocorticotropic Hormone ◽  
Brain Mri ◽  
Pituitary Hormones ◽  
Hormone Deficiency ◽  
Normal Brain ◽  
Sheehan’S Syndrome ◽  
Isolated Acth Deficiency ◽  
Acth Deficiency ◽  
Sheehan's Syndrome

Abstract Introduction: Isolated adrenocorticotropic hormone (ACTH) deficiency is a rare pituitary hormone deficiency defined by secondary adrenal insufficiency and normal secretion of all other pituitary hormones. Patients present with fatigue, weakness, weight loss, anorexia, nausea, low cortisol levels and low ACTH levels. Isolated ACTH deficiency is more common in males and usually presents in the fifth decade of life. Main mechanisms involved in the pathogenesis are genetics and autoimmune causes, traumatic brain injury and infarction of the pituitary postpartum, known as Sheehan’s syndrome. Sheehan’s syndrome is characterized by postpartum hemorrhage, failure to lactate and menstrual irregularities and it can occur from immediate postpartum period to years after delivery. The most common hormone deficiencies are prolactin and growth hormone. Empty sella is the most common finding on brain MRI. We are reporting a case of a woman in her third decade with isolated ACTH deficiency due to Sheehan’s syndrome two years postpartum, able to lactate, with normal menses and normal brain MRI. Clinical Case: A 33-year-old woman G3P3A0 with hypothyroidism who was referred to Endocrinology clinics due to tiredness, fatigue and weakness. She reported postpartum hemorrhage requiring 4 PRBC transfusions and IV steroids after last pregnancy 5 years ago. Patient was able to lactate after pregnancy and continued in her usual state of health until 3 years ago when she referred loss of consciousness with traumatic head injury due to hypoglycemia. At Endocrinology office physical examination and vital signs were unremarkable, including no blood pressure or heart rate variations with positional changes. Despite hypothyroidism being adequately controlled, she continued with extreme fatigue and weakness affecting her quality of life, for which cortisol and ACTH levels were ordered. Laboratories showed normal electrolytes, negative autoantibodies, cortisol 0.20 μg/dL (5-25 μg/dL) and ACTH 22 pg/mL (10-60 pg/mL) suggesting partial isolated ACTH deficiency. ACTH stimulation test was done and noted with suboptimal response. Evaluation of other anterior pituitary hormones was normal. Brain MRI showed normal pituitary gland. She was started on hydrocortisone in AM and PM and symptoms resolved. Conclusion: Immediate recognition of isolated ACTH deficiency due to Sheehan’s syndrome is necessary due to the availability of effective treatment and morbidity and mortality associated with this serious condition. To our knowledge isolated ACTH deficiency due to Sheehan’s syndrome in which the patient was able to lactate and normal findings on brain MRI has not previously been reported.References: Shivaprasad C. Sheehan’s Syndrome: Newer advances. Indian J Endocrinol Metab. 2011 Sep; 15(3): S203-207. DOI:10.4103/2230-8210.84869.

Ketotic Hypoglycemia and Hypopituitarism

PEDIATRICS ◽  
1979 ◽  
Vol 63 (3) ◽  
pp. 414-415
Author(s):  
William B. Lorentz
Keyword(s):  
Amino Acids ◽  
Growth Hormone ◽  
Short Stature ◽  
Adrenocorticotropic Hormone ◽  
Serum Levels ◽  
Pituitary Function ◽  
Acth Deficiency ◽  
Ketotic Hypoglycemia ◽  
Gluconeogenic Substrate

A 5-year-old girl had hypoglycemia and was of short stature. Studies of pituitary function demonstrated combined growth hormone and adrenocorticotropic hormone (ACTH) deficiency. She was shown to have ketotic hypoglycemia. In contrast to patients previously reported with hypopituitarism and ketotic hypoglycemia, she had no deficiency of gluconeogenic substrate. Serum levels of alanine and other gluconeogenic amino acids were normal during fasting and hypoglycemia. These studies suggest that inadequate gluconeogenic precursors are not the cause of her ketotic hypoglycemia. Ketotic hypoglycemia in association with hypopituitarism may be secondary to multiple biochemical defects.

scholarly journals Patient with isolated adrenocorticotropic hormone (ACTH) deficiency who was depressive before glucocorticoid replacement, and exhibited stupor during continuous ACTH test

2011 ◽  
Vol 65 (5) ◽  
pp. 535-535 ◽  
Author(s):  
Masaki Miyasaka ◽  
Kazuyasu Kojima ◽  
Mutsuko Yasuda ◽  
Tomoatsu Oji ◽  
Fumiatsu Yakushiji ◽  
...  
Keyword(s):  
Adrenocorticotropic Hormone ◽  
Acth Test ◽  
Acth Deficiency

Immunotherapy-induced isolated ACTH deficiency in cancer therapy

2021 ◽  
Author(s):  
Pedro Iglesias ◽  
Inmaculada Peiró ◽  
Betina Biagetti ◽  
Miguel Paja Fano ◽  
Diana Ariadel Cobo ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Clinical Characteristics ◽  
Adrenocorticotropic Hormone ◽  
Median Overall Survival ◽  
Immune Checkpoint Inhibitor ◽  
Checkpoint Inhibitor ◽  
Isolated Acth Deficiency ◽  
Acth Deficiency ◽  
Therapeutic Outcomes

Central adrenal insufficiency (AI) due to isolated adrenocorticotropic hormone (ACTH) deficiency (IAD) has been recently associated with immune checkpoint inhibitor (ICI) therapy. Our aim was to analyze the prevalence, clinical characteristics, and therapeutic outcomes in cancer patients with IAD induced by ICI therapy. A retrospective and multicenter study was performed. From a total of 4,447 cancer patients treated with ICI antibodies, 37 (0.8%) [23 men (62.2%), mean age 64.7 ± 8.3 years (range 46-79 yr)] were diagnosed with IAD. The tumor most frequently related to IAD was lung cancer (n=20, 54.1%), followed by melanoma (n=8, 21.6%). The most commonly ICI antibody inhibitor reported was nivolumab (n=18, 48.6%), pembrolizumab (n=16, 43.2%) and ipilimumab (n=8, 21.6%). About half of the patients (n=19, 51.4%) had other immune-related adverse events, mainly endocrine adverse effects (n=10, 27.0%). IAD was diagnosed at a median time of 7.0 months (IQR, 5-12) after starting immunotherapy. The main reported symptom at presentation was fatigue (97.3%), followed by anorexia (81.8%) and general malaise (81.1%). Mean follow-up time since IAD diagnosis was 15.2 ± 12.5 months (range 0.3-55 months). At last visit all patients continued with hormonal deficiency of ACTH. Median overall survival since IAD diagnosis was 6.0 months. In conclusion, IAD is a rare but a well-established complication associated with ICI therapy in cancer patients. It develops around 7 months after starting treatment, mainly anti-PD1 antibodies. Recovery of the corticotropic axis function should not be expected.

Anosmia and isolated ACTH deficiency following a road traffic accident

1990 ◽  
Vol 73 (3) ◽  
pp. 453-454 ◽  
Author(s):  
J. E. Scoble ◽  
C. W. H. Havard
Keyword(s):  
Head Injury ◽  
Road Traffic Accident ◽  
Traffic Accident ◽  
Adrenocorticotropic Hormone ◽  
Road Traffic ◽  
Content Type ◽  
Isolated Acth Deficiency ◽  
Acth Deficiency ◽  
Pituitary Dysfunction ◽  
Fine Print

✓ A 42-year-old man suffered a head injury in a road traffic accident and subsequently developed anosmia and isolated adrenocorticotropic hormone (ACTH) deficiency. There was no other evidence of pituitary dysfunction. No previous case of isolated ACTH deficiency following head injury has been reported.

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