J Korean Soc Endocrinol.  1998 Dec;13(4):646-651.

A Case of Isolated ACTH Deficiency Manifestated by Atrial Fibrillation and Hypoglycemia

• Kim WS
• Lee KS
• Song SK
• Seo IS
• Choi SJ
• Kim DY

Abstract

Isolated ACTH deficiency is a rare cause of secondary adrenocortical insufficiency caused by the defect of synthesis or release of ACTH in pituitary gland. The clinical presentation can be simiilar to that of primary adrenal insufficiency, but there is a greater tendency for hypoglycemia and absence of hyperpigmentation. The patient, 80 year-old female, was admitted in chief complaint of deteriorated mental states. On admission, serum sodium was 127mEq/L, potassium 4.4mEq/L, blood glucose 27mg/dL and on routine E.C.G. was atrial fibrillation was revealed. The basal morning serum cortisol level was 9.97 pg/dL it dosent respond to insulin-induced hypoglycemia enoughly, but other pituitary functions were intact in pituitary cocktail stimulation test. In CRH stimulation test, there was no remarkable response in serum ACTH and cortisol level. Brain MRI failed to reveal any anatomic abnormalities of the sellar or suprasellar area consistent with the defect of pituitary ACTH secretion. This case was a isolated ACTH deficiency, So, we conclude that associated with atrail fibrillation and hypoglycemia.

MeSH Terms

Addison Disease
Adrenocorticotropic Hormone*
Aged, 80 and over
Atrial Fibrillation*
Blood Glucose
Brain
Female
Humans
Hydrocortisone
Hyperpigmentation
Hypoglycemia*
Magnetic Resonance Imaging
Pituitary Gland
Potassium
Sodium
Adrenocorticotropic Hormone
Blood Glucose
Hydrocortisone
Potassium
Sodium