Isolated ACTH Deficiency and TSH Deficiency in the Adult

Burke, C. W.; Moore, Ray; Rees, Lesley; Bottazzo, Gian Franco; Mashiter, Κ.; Bitensky, Lucille

doi:10.1177/014107687907200505

Cited by 28 publications

(1 citation statement)

References 41 publications

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“…1992;152:1705-1712 Ever since a patient with failure of adrenocortical func¬ tion consequent to selective impairment of corticotropin secretion was first described in 1954 by Sternberg and colleagues,1 similar cases have been increasingly detected because of the heightened awareness of this disorder among endocrinologists and the clinical application of hypothalamic hypophysiotropic hormones. Since a report of our first case in 1976,2 we have diagnosed and treated 10 additional cases and found that several problems needed clarification. A review of the literature revealed that most articles are single case reports.…”

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confidence: 99%

Isolated Corticotropin Deficiency in Adults

Yamamoto

Fukuyama²,

Hasegawa³

et al. 1992

Arch Intern Med

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The clinical and laboratory findings in 76 patients with isolated corticotropin deficiency (10 of our own and 66 from literature) were analyzed with the following observations. With the exceptions of hyperpigmentation and hyperkalemia, the similarity of symptoms and signs to those of Addison's disease and their reversibility by glucocorticoids indicate that most, but not all, manifestation of isolated corticotropin deficiency is caused by glucocorticoid deficiency. Isolated corticotropin deficiency seems to be of pituitary origin in most patients, as shown by lack of corticotropin response to insulin-induced hypoglycemia, vasopressin, or corticotropin-releasing factor. Secretion of other pituitary hormones is frequently abnormal, which is mostly attributable to glucocorticoid deficiency. Although the pathogenesis of isolated corticotropin deficiency is unknown in most patients, association with other autoimmune endocrinopathies, postpartum onset in women, or serum antipituitary antibodies suggests an autoimmune pathogenesis in some patients. In two of our 10 patients, cancer developed during glucocorticoid treatment. More observations of complications and long-term prognosis following glucocorticoid therapy are needed for optimal clinical decision making.

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confidence: 99%