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Isolated ACTH deficiency confirmed by ACTH radioimmunoassay

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Abstract

A 28 year old woman presented with symptoms and biochemical findingssuggesting hypoglycemia. Detailed endocrine investigations indicated secondary adrenocortical insufficiency with no rise in plasma ACTH or plasma Cortisol following insulin-induced hypoglycemia or vasopressin infusion. The adrenal glands however produced Cortisol normally following prolonged stimulation with depot tetracosactrin. Other anterior pituitary hormones were released normally following appropriate stimulation tests. The literature on isolated ACTH deficiency is briefly reviewed, and this case represents one of the few reports in which the diagnosis has been substantiated by ACTH radioimmunoassay.

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References

  1. Steinberg A., Stechter F.R., Segal H.I. True pituitary Addison’s disease, a pituitary unitrophic deficiency; fifteen year followup. J. Clin. Endocrinol. Metab. 14: 1515, 1954.

    Google Scholar 

  2. Limjuco R.A., Sherman L., Kolodny H.D. Isolated ACTH deficiency. N.Y. State J. Med. 76: 439, 1976.

    PubMed  CAS  Google Scholar 

  3. Takayama H., Inada M., Nakai Y., Kato Y., Yanagihara K. Case of isolated ACTH deficiency. Folia Endocrinol. Jpn. 50: 462, 1974.

    CAS  Google Scholar 

  4. Yamamoto T., Ogiwara T., Miyai K., Kumahara Y., Hirata Y. Primary hypothyroidism associated with isolated ACTH deficiency. Jap. J. Clin. Med. 32: 2416, 1974.

    CAS  Google Scholar 

  5. Le Roith D., Keeton G.R. Isolated partial deficiency of adrenocorticotrophic hormone. S. Afr. Med. J. 49: 1754, 1975.

    PubMed  CAS  Google Scholar 

  6. Lucking T., Willig R.P. Selectiva ACTH-Mangel bei zwei geschwistern. Dtsch. Med. Wochenschr. 100: 2646, 1975.

    Article  PubMed  CAS  Google Scholar 

  7. Aubert P., Lainee J., Duron F. Les insuffisances surrénales par déficit corticotrope isolé. Nouv. Presse Med. 5: 2227, 1976.

    PubMed  CAS  Google Scholar 

  8. Fehm H.L., Voigt K.H., Lang R., Hetzel W.D., Pfeiffer E.F. Adrenal insufficiency secondary to hypothalamic corticortophin releasing factor (CRF) insufficiency with hyper-pigmentation; a case report. Horm. Metab. Res. 8: 470, 1976.

    Article  PubMed  CAS  Google Scholar 

  9. Kratz F., Graef V. Uber einen Fall einer Graviditat bei isoliertem Ausfall von ACTH. Klin. Wochenschr. 51: 1062, 1973.

    Article  Google Scholar 

  10. Ono I., Kato T., Sawada E. A case of isolated ACTH deficiency. J. Jpn. Soc. Intern. Med. 61: 1314, 1972.

    Article  CAS  Google Scholar 

  11. Satterfield R.G., Williamson H.O. Isolated ACTH deficiency and pregnancy. Obstet. Gynecol. 48: 693, 1976.

    PubMed  CAS  Google Scholar 

  12. Baba S., Takase S., Uenoyama R., Morita S., Mizoi Y., Hishida S. Isolated ACTH deficiency found through alchohol-induced hypoglycaemic coma. Horm. Metab. Res. 8: 274, 1976.

    Article  PubMed  CAS  Google Scholar 

  13. Mejer J. Isolated adrenocorticotrophic hormone deficiency: a case report. Dan. Med. Bull. 23: 274, 1976.

    Google Scholar 

  14. Few J.D. A method for the analysis of urinary 1 7-hydroxycorticosteroids. J. Endocrinol. 22: 31, 1961.

    Article  PubMed  CAS  Google Scholar 

  15. Appleby J.I., Gibson G., Norymberski J.K., Stubbs R.D. Indirect analysis of corticosteroids. I. The detection of 17 OHCS. Biochem. J. 60: 453, 1955.

    PubMed  CAS  PubMed Central  Google Scholar 

  16. Drekter I.J., Heisler A., Seism G.R., Stern S., Pearson S., McGavack T.H. The detection of urinary steroids. I. The preparation of pigment-free extracts and a simplified procedure for the estimation of total 17 ketosteroids. J. Clin. Endocrinol. Metab. 12: 55, 1952.

    Article  PubMed  CAS  Google Scholar 

  17. Murphy B.E.P. Some studies of the protein-binding of steroids and their application to the routine micro and ultra micro measurement of various steroids in body fluids by competitive protein-binding radioassay. J. Clin. Endocrinol. Metab. 27: 973, 1967.

    Article  PubMed  CAS  Google Scholar 

  18. Donald R.A. Application of the coated charcoal separation method to the radioimmunoassay of plasma corticotrophm. J. Endocrinol. 41: 499, 1968.

    Article  PubMed  CAS  Google Scholar 

  19. Holdaway I.M., Frengley P.A., Scott D.J., Ibbertson H.K. Bromoergocryptine treatment of acromegaly persisting following conventional therapy. Clin. Endocrinol. (Oxf.) 8: 45, 1978.

    Article  CAS  Google Scholar 

  20. Wide L. Radioimmunoassays employing immunosorbents. Acta Endocrinol. (Suppl.) (Kbh.) 142: 207, 1969

    CAS  Google Scholar 

  21. Midgley R.A. Radioimmunoassay for human follicle-stimulating hormone. J. Clin. Endocrinol. Metab. 27: 295, 1967.

    Article  PubMed  CAS  Google Scholar 

  22. Patel Y.C., Burger H.G., Hudson B. Radioimmunoassay of serum thyrotropin: Sensitivity and specificity. J. Clin. Endocrinol. Metab. 33: 768, 1971.

    Article  PubMed  CAS  Google Scholar 

  23. Gluckman P.D., Holdaway I.M. Prolactin and somatomedin studies in the syndrome of growth hormone-independent growth. Clin. Endocrinol. (Oxf.) 5: 545, 1976.

    Article  CAS  Google Scholar 

  24. Croxson M.S., Ibbertson H.K. Low serum triiodothyronine (T3) and hypothyroidism in anorexia nervosa. J. Clin. Endocrinol. Metab. 44: 167, 1977.

    Article  PubMed  CAS  Google Scholar 

  25. Hodges J.R. The hypothalamus and pituitary ACTH release. Prog. Brain. Res. 32: 12, 1970.

    Article  PubMed  CAS  Google Scholar 

  26. Hung W., Migeon C.J. Hypoglycaemia in a two-year old boy with adrenocorticotropic hormone (ACTH) deficiency (probably isolated) and adrenal medullary unresponsiveness to insulin-induced hypoglycaemia. J. Clin. Endocrinol. Metab. 28: 146, 1968.

    Article  PubMed  CAS  Google Scholar 

  27. Cleveland W.W., Greerv O.C, Migeon C.J. A case of proved adrenocorticotropin deficiency. J. Paediatr. 57: 376, 1960.

    Article  CAS  Google Scholar 

  28. Abramson E.A., Arky R.A. Coexistent diabetes mellitus and isolated ACTH deficiency: report of a case. Metabolism 17: 492, 1968.

    Article  PubMed  CAS  Google Scholar 

  29. Waxman D.A., Berk P.D., Schalch D., Tschudy D.P. Isolated adrenocorticotropic hormone deficiency in acute intermittent porphyria. Ann. Intern. Med. 70: 317, 1969.

    Article  PubMed  CAS  Google Scholar 

  30. Woeber K.A., Arky R.A. Hypoglycaemia as the result of isolated corticotrophin- deficiency. Br. Med. J. 2: 857, 1965.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  31. Steer P., Marnell R., Werk E.E. Clinical alchohol hypoglycaemia and isolated adrenocorticotropic hormone deficiency. Ann. Intern. Med. 71: 343, 1969.

    Article  PubMed  CAS  Google Scholar 

  32. Oczkowicz A., Mazurowa A., Pawlikowsky M. Severe hypoglycaemic coma in a male with pituitary-adrenal insufficiency. Endockrynol. Pol. 22: 585, 1971.

    CAS  Google Scholar 

  33. Jorgensen P.I., Sele V., Buus O., Damkjoer M. Detailed hormone studies during and after pregnancy in a previously hypophysectomized patient. Acta Endocrinol. 73: 117, 1973.

    PubMed  CAS  Google Scholar 

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Ooi, T.C., Holdaway, I.M., Donald, R.A. et al. Isolated ACTH deficiency confirmed by ACTH radioimmunoassay. J Endocrinol Invest 3, 45–49 (1980). https://doi.org/10.1007/BF03348216

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  • DOI: https://doi.org/10.1007/BF03348216

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