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KMID : 0374920140350010137
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Inje Medical Journal
2014 Volume.35 No. 1 p.137 ~ p.143
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A Case of Isolated Adrenocorticotropic Hormone Deficiency Misdiagnosed as Hypothyroidism
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Moon Seok-Jun
Shin Ho-Cheol
Yang Ju-Il
Ong Sung-Moon
Lee Ga-Hee
Lee Soon-Hee
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Abstract
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Isolated adrenocorticotropic hormone (ACTH) deficiency is a rare cause of secondary adrenal insufficiency that does not accompany structural and functional abnormalities of other pituitary hormones. Clinical identification of ACTH deficiency is difficult, as it displays various symptoms that are non-specific. Additionally, it can be fatal when accompanied with acute stress. We present a case of a 65-year-old man with symptoms of appetite loss, adynamia, cold intolerance, and muscle pains for the past 1 year, who was admitted to our hospital after being misdiagnosed with hypothyroidism owing to abnormal findings in a thyroid function test at an other clinic. He received treatment for hypothyroidism at that clinic, without any improvement. As secondary hypothyroidism and hypopituitarism were suspected, combined pituitary function test and pituitary magnetic resonance imaging were performed, and the diagnosis of isolated ACTH deficiency was confirmed. The symptoms improved after treatment with hydrocortisone, and he is currently being monitored on an outpatient basis.
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KEYWORD
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Adrenocorticotropic Hormone, Adrenal Insufficiency, Hypothyroidism
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