Isolated adrenocorticotropic hormone deficiency, thyroid autoimmunity, and transient hyperprolactinemia.
OBJECTIVE
To describe a case of isolated adrenocorticotropic hormone (ACTH) deficiency associated with thyroid autoimmunity, subclinical hypothyroidism, and transient hyperprolactinemia.


METHODS
We present a detailed case report, including results of laboratory studies and magnetic resonance imaging, and discuss potential contributing factors in this setting.


RESULTS
In a 23-year-old woman with isolated ACTH deficiency accompanied by thyroid autoimmunity (Hashimoto's thyroiditis), subclinical primary hypothyroidism, and hyperprolactinemia, magnetic resonance imaging of the pituitary showed normal findings but dynamic stimulation testing of the pituitary gland indicated an isolated ACTH deficiency with intact growth hormone and gonadotropin secretory reserves. The cortisol response to the short ACTH stimulation test was subnormal. Therapy with prednisolone (5 mg/day) and levothyroxine (100 microg/day) was initiated. Results of thyroid function tests were normalized after 1 month, the prolactin level decreased to normal after 1 year, and titers of thyroid autoantibodies decreased substantially after 1.5 years of treatment.


CONCLUSIONS
The correction of the related glucocorticoid deficiency resulted in resolution of the hyperprolactinemia and a decrease in titers of thyroid autoantibodies.
Gürlek
A
A
Hacettepe University School of Medicine, Department of Internal Medicine, Division of Endocrinology, Ankara, Turkey.
Nar
A
A
Gedik
O
O
D000324:Adrenocorticotropic Hormone / Q000172:deficiency* / Q000627:therapeutic use; D000328:Adult; D003346:Corticotropin-Releasing Hormone / Q000627:therapeutic use; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D020249:Hormone Replacement Therapy; D006728:Hormones / Q000097:blood; D019382:Human Growth Hormone / Q000627:therapeutic use; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D006966:Hyperprolactinemia / Q000150:complications* / Q000188:drug therapy; D007037:Hypothyroidism / Q000150:complications / Q000473:pathology; D007986:Luteinizing Hormone / Q000627:therapeutic use; D008279:Magnetic Resonance Imaging; D011239:Prednisolone / Q000627:therapeutic use; D013960:Thyroid Function Tests; D013967:Thyroiditis, Autoimmune / Q000150:complications* / Q000188:drug therapy; D013974:Thyroxine / Q000627:therapeutic use
D005938:Glucocorticoids; D006728:Hormones; D019382:Human Growth Hormone; D000324:Adrenocorticotropic Hormone; D007986:Luteinizing Hormone; D003346:Corticotropin-Releasing Hormone; D011239:Prednisolone; D013974:Thyroxine; D006854:Hydrocortisone