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Isolated adrenocorticotropic hormone deficiency manifested after COVID-19
Ryo Shimba1, Shunichiro Hanai2, Ryosuke Ito2
1Department of Diabetes and Endocrinology, University of Yamanashi Hospital, 1110 Shimokato, Chuo-shi, Yamanashi, 409-3898, Japan.
Summary
Persistent symptoms after COVID-19 may indicate hidden adrenal insufficiency. This case highlights isolated adrenocorticotrophic hormone (ACTH) deficiency mimicking prolonged COVID-19, emphasizing the need for careful diagnosis.
Area of Science:
- Endocrinology
- Infectious Diseases
- Internal Medicine
Background:
- Coronavirus disease 2019 (COVID-19) and its sequelae, such as long COVID, can present with nonspecific symptoms.
- These symptoms can overlap with those of adrenal insufficiency, potentially leading to underdiagnosis.
Observation:
- A 53-year-old man with COVID-19 experienced persistent fever, loss of appetite, fatigue, and hyponatremia post-antiviral treatment.
- Endocrinological tests revealed low baseline cortisol and ACTH levels, with no response to ACTH stimulation, indicating isolated ACTH deficiency (IAD).
Findings:
- The patient was diagnosed with acute adrenal insufficiency secondary to IAD following COVID-19.
- Hydrocortisone treatment resolved the symptoms and hyponatremia, with no recurrence observed.
Implications:
- COVID-19 can unmask or trigger adrenal insufficiency, particularly IAD.
- Adrenal insufficiency should be considered in patients with persistent nonspecific symptoms after COVID-19 infection.
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