An adult case of neurohypophyseal ectopy presenting ACTH deficiency and partial GH deficiency.
A case of ACTH deficiency and partial GH deficiency associated with neurohypophyseal ectopy is described. A 42-year-old woman of short stature was admitted for hypoglycemic coma. The patient had hypocortisolemia, an increase in urinary 17-OHCS after consecutive injections of ACTH-Z, and a low plasma ACTH level which showed no response to corticotropin-releasing factor. This indicated the presence of ACTH deficiency. The plasma GH level showed a blunted response to insulin-induced hypoglycemia, but its response to GRF was preserved. Other hypothalamo-pituitary axes were intact. T1-weighted magnetic resonance imaging demonstrated ectopic neurohypophyseal tissue and a tiny anterior pituitary remnant. ACTH deficiency and partial GH deficiency might have developed as a consequence of pituitary stalk injury and inadequate regeneration of the anterior lobe.
Takamura
T
T
Department of Internal Medicine, Kanazawa Red Cross Hospital, Japan.
Ohsawa
K
K
Nishimura
Y
Y
Yamagishi
S
S
Komatsu
Y
Y
Iwata
A
A
Osada
S
S
Nagai
Y
Y
Miyakoshi
H
H
Kobayashi
K
K
D000324:Adrenocorticotropic Hormone / Q000097:blood / Q000172:deficiency*; D000328:Adult; D005260:Female; D013006:Growth Hormone / Q000097:blood / Q000172:deficiency*; D006801:Humans; D007018:Hypopituitarism / Q000097:blood / Q000209:etiology*; D010904:Pituitary Gland, Posterior / Q000002:abnormalities*
D000324:Adrenocorticotropic Hormone; D013006:Growth Hormone