Adrenal insufficiency secondary to hypothalamic corticotropin releasing factor (CRF) insufficiency with hyperpigmentation: a case report.
Partial adrenocortical insufficiency as a result of an insufficiency of the hypothalamic corticotropin releasing factor (CRF) was demonstrated in a 53-year-old female patient. Somatotropic, gonadotropic and thyreotropic functions of the pituitary gland were shown to be normal by a simultaneous pituitary stimulation test. This held true especially for the adrenocorticotrophic function: administration of lysine-vasopressin induced a normal rise in immunoreactive plasma-ACTH. Thus, a pituitary defect as a primary cause of the disease could be excluded and evidence was provided that there was a lack in hypothalamic stimulae absence of elevated ACTH levels hyperpigmentation of the skin existed. Possible explanations are discussed.
D000309:Adrenal Insufficiency / Q000209:etiology*; D000324:Adrenocorticotropic Hormone / Q000494:pharmacology; D003346:Corticotropin-Releasing Hormone / Q000172:deficiency*; D004487:Edema / Q000209:etiology; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D008875:Middle Aged; D010859:Pigmentation Disorders / Q000209:etiology*; D010901:Pituitary Function Tests
D000324:Adrenocorticotropic Hormone; D003346:Corticotropin-Releasing Hormone; D006854:Hydrocortisone