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Periodic ACTH discharge.

T Sato, T Funahashi, M Mukai

    The Journal of Pediatrics
    |August 1, 1980
    PubMed
    Summary
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    This case study describes a girl with cyclical attacks of abdominal pain and vomiting, likely due to periodic excessive adrenocorticotropic hormone (ACTH) release. Treatment with chlorpromazine effectively suppressed these episodes.

    Area of Science:

    • Pediatric Endocrinology
    • Neuroendocrinology
    • Clinical Case Study

    Background:

    • Cyclical symptoms in children can present diagnostic challenges.
    • Understanding the interplay between the pituitary and adrenal glands is crucial for diagnosing hormonal imbalances.

    Observation:

    • A 9 1/2-year-old girl experienced recurrent episodes of abdominal pain, vomiting, emotional distress, and weight fluctuations over two years.
    • Clinical signs included facial plethora, hypertension, and temporary hyperglycemia with glycosuria during attacks.

    Findings:

    • Laboratory results revealed elevated plasma ACTH, cortisol, and urinary 17-OHCS, alongside low plasma osmolality and hyponatremia.
    • Normal urinary catecholamines and porphyrins ruled out other potential causes.
    • Symptoms resolved between episodes, indicating a periodic disorder.

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    Implications:

    • The findings suggest a rare disorder characterized by periodic excessive adrenocorticotropic hormone (ACTH) secretion.
    • Chlorpromazine demonstrated efficacy in managing the cyclical symptoms.
    • The underlying etiology of this periodic ACTH release remains unidentified, warranting further investigation.