Hypoglycemia As Initial Presentation In Patient With Isolated Acth Deficiency

Alabdrabalnabi, Fatimah; Saeed, Zahra A. Al; Elamin, Yasir

doi:10.4158/accr-2020-0093

Cited by 3 publications

(1 citation statement)

References 15 publications

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“…Corticotrope cells are often the first to be affected in lymphocytic hypophysitis, and adult isolated corticotrope deficiency was suggested to have a link with an autoimmune process [ 18 ]. De Bellis et al demonstrated higher pituitary and hypothalamic antibody titers, respectively, in 14.8 and 18.5% of patients with isolated corticotrope deficiency [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

Late-Onset Isolated Corticotrope Deficiency in a Woman with Down Syndrome

Oueslati

Jemaa

Yazidi

et al. 2021

Case Reports in Endocrinology

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Isolated corticotrope deficiency is a rare cause of secondary adrenocortical insufficiency. Its occurrence in patients with Down syndrome is exceptional. Herein, we report a case of an isolated corticotrope deficiency diagnosed at the age of 33 years in a woman with Down syndrome and discuss its possible mechanisms. A 33-year-old woman with Down syndrome was referred to our department for the investigation of low blood pressure. She complained of asthenia, dizziness, and palpitation with arterial hypotension for the past 4 years. The thyroid function was normal and anti-thyroperoxidase antibodies were negative. The peak of cortisol level in response to the insulin-induced hypoglycemia test was 9.4 μg/dl. ACTH level was normal, indicating corticotrope deficiency. Other pituitary hormones were normal. Magnetic resonance imaging scan revealed a partially empty sella turcica. Genetic analysis showed no mutations and no copy number variants of the TBX19 and NFKB2 genes. The mechanism of isolated corticotrope deficiency is unclear, but it may be induced by autoimmune mechanism in similar to other disorders of patients with Down syndrome.

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Section: Discussionmentioning

confidence: 99%

Late-Onset Isolated Corticotrope Deficiency in a Woman with Down Syndrome

Oueslati

Jemaa

Yazidi

et al. 2021

Case Reports in Endocrinology

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Isolated Adrenocorticotropic Hormone Deficiency Diagnosed After the Cessation of Glucocorticoid Therapy for Eosinophilic Esophagitis: A Case Report

Iwamura,

Watts,

Sakuraba

et al. 2024

Cureus

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Isolated adrenocorticotropic hormone deficiency (IAD) is a rare pituitary disorder that can cause adrenal insufficiency. However, due to its nonspecific symptoms, its diagnosis is often difficult and may be delayed. Patients with IAD require lifelong glucocorticoid (GC) replacement therapy. Contrastingly, GC-induced secondary adrenal insufficiency is a reversible condition that arises when patients receiving GC therapy reduce their GC dosage or discontinue therapy. Differentiating between IAD and GC-induced secondary adrenal insufficiency is clinically crucial. We report a unique case that required differentiation between these two conditions. A 71-year-old Japanese woman presented with symptoms of adrenal insufficiency after discontinuation of GC therapy for eosinophilic esophagitis. We conducted detailed interviews and repeated the endocrinological examinations. We concluded that her symptoms were owing to IAD rather than GC-induced secondary adrenal insufficiency. She began a lifelong hydrocortisone replacement therapy. This case suggests that when caring for patients undergoing GC therapy, it is important to consider the possibility of coexisting IAD and arrange endocrinological examinations if signs of adrenal insufficiency arise during the gradual reduction of GC treatment.

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