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Co-existent primary hypothyroidism and isolated ACTH deficiency
Acta Endocrinologica
|July 1, 1976
Summary
This study documents a rare case of simultaneous isolated adrenocorticotrophin (ACTH) deficiency and primary hypothyroidism in a 52-year-old man, highlighting diagnostic challenges and potential pathogenesis.
Area of Science:
- Endocrinology
- Internal Medicine
- Clinical Case Study
Background:
- Simultaneous occurrence of multiple anterior pituitary hormone deficiencies is uncommon.
- Isolated adrenocorticotrophin (ACTH) deficiency and primary hypothyroidism can present diagnostic challenges.
Purpose of the Study:
- To document a rare case of co-existing isolated ACTH deficiency and primary hypothyroidism.
- To investigate the secretory reserves of anterior pituitary hormones after initial treatment.
Main Methods:
- Radioimmunoassays were used to determine six anterior pituitary hormones.
- Stimulation tests included insulin-induced hypoglycemia and metyrapone infusion.
- Urinary 17-hydroxycorticosteroids and serum thyroid hormones were measured.
Main Results:
- The patient presented with reduced urinary 17-hydroxycorticosteroids, responsive to ACTH stimulation.
- Primary hypothyroidism was indicated by low basal metabolic rate and thyroid hormones.
- Growth hormone response to hypoglycemia was normal, but ACTH and cortisol showed no rise.
- Metyrapone infusion did not augment plasma ACTH levels.
Conclusions:
- The case highlights the importance of comprehensive pituitary hormone evaluation in patients with multiple endocrine deficiencies.
- The pathogenesis of these co-existing deficiencies requires further investigation.
- Early diagnosis and management are crucial for improving patient outcomes.