Isolated ACTH deficiency associated with Hashimoto's thyroiditis: report of a case

A 65-year-old female with general malaise, anorexia and marked emaciation was studied by secretion stimulation tests on 6 anterior pituitary hormones. Only ACTH showed no response and the other 5 hormones responded normally. The basal value of antidiuretic hormone was normal. She was found to be suffered from primary hypothyroidism. Though neither antithyroid antibodies nor other autoantibodies were found, Hashimoto's thyroiditis was confirmed by a thyroid open biopsy. Neoplastic lesions of the hypophysis were ruled out by various X-ray and CT examinations of the sella turcica as well as the brain. The case was concluded to be isolated ACTH deficiency associated with Hashimoto's thyroiditis. The substitution therapy using small doses of adrenocortical hormone and thyroid hormone has kept her well and she has been living normally for these five years.