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Isolated adrenocorticotropic hormone (ACTH) deficiency.
Acta Pathologica Japonica
|November 1, 1982
Summary
Isolated adrenocorticotropic hormone (ACTH) deficiency in a 72-year-old woman presented with anorexia. Postmortem analysis revealed a selective loss of ACTH-secreting pituitary cells.
Area of Science:
- Endocrinology
- Pathology
Background:
- Adrenocorticotropic hormone (ACTH) deficiency is a rare endocrine disorder.
- This case involves a 72-year-old female patient presenting with symptoms suggestive of hormonal imbalance.
Observation:
- The patient exhibited anorexia and malaise with normal levels of other pituitary hormones (HGH, PRL, LH, FSH, TSH).
- Despite extremely low cortisol levels, plasma ACTH did not rise appropriately, but cortisol responded to ACTH stimulation.
- Postmortem examination of the anterior pituitary revealed a decrease in basophilic/PAS-positive cells and a selective loss of ACTH-secreting cells (corticotrophs).
Findings:
- Immunohistochemical and electron microscopy studies confirmed the scarcity of corticotrophs.
- Adrenocortical cells showed atrophy and degeneration, with narrowed zona fasciculata and reticularis, and a slightly widened zona glomerulosa.
Implications:
- This case highlights a rare instance of isolated ACTH deficiency.
- The findings suggest a specific pathology affecting corticotrophs in the anterior pituitary.
- Understanding such selective pituitary cell loss is crucial for diagnosing and managing related endocrine disorders.