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부신피질자극호르몬 단독 결핍 1례

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Affiliated Author(s)
이인규
Alternative Author(s)
Lee, In Kyu
Journal Title
Keimyung Medical Journal
Issued Date
1997
Keyword
부신피질자극호르몬단독결핍뇌하수체ACTH deficiencyHyperprolactinemiaHyponatremia
Abstract
Isolated ACTH deficiency is a rare disorder which shows secondary adrenal insufficiency with normal states of other pituitary hormones.
A 56-year-old postmenopausal woman complaining general weakness and intermittent mental confusion presented negligible serum cortisol and ACTH level with hyperprolactinemia and mild hyponatremia. Rapid ACTH stimulation test did not show significant increase of serum cortisol level. Combined pituitary stimulation test showed negligible response of cortisol and ACTH, and slightly decreased response of prolactin and gonadotropin. But the responses of TSH and GH were normal. There was no evidence of organic pituitary of hypothalamic lesion in brain MRI and antithyroid autoantibody was not detected in serum.
After receiving 12 months of glucocorticoid replacement therapy, she skipped the medicine for 3 weeks and we performed follow-up endocrinologic tests. Serum ACTH and cortisol level was also negligible and prolonged ACTH simulation test showed normal response of serum cortisol. CRF stimulation test showed no response of serum ACTH. Basal prolactin level was decreased to near normal and combined pituitary stimulation test showed normal response of prolactin with slightly blunted response of TSH and GH.
We concluded that the case was nonautoimmune origined isolated ACTH deficiency which was accompanied by hyperprolactinemia and resultant deficiency of gonadotropin, so we report this case with review of literatures.
Alternative Title
A Case of Isolated ACTH Deficiency
Department
Dept. of Internal Medicine (내과학)
Institute for Medical Science (의과학 연구소)
Publisher
Keimyung University School of Medicine
Citation
박경식 et al. (1997). 부신피질자극호르몬 단독 결핍 1례. Keimyung Medical Journal, 16(3), 397–404.
Type
Article
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/15044
Appears in Collections:
2. Keimyung Medical Journal (계명의대 학술지) > 1997
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
3. Research Institutues (연구소) > Institute for Medical Science (의과학연구소)
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