title: Three patients with isolated adrenocorticotropin deficiency presenting with neuroleptic malignant syndrome-like symptoms.
abstract: We report 3 patients with isolated adrenocorticotropin (ACTH) deficiency presenting with neuroleptic malignant syndrome (NMS)-like symptoms. All patients were in their 60's or 70's and showed consciousness disturbance, a high-grade fever, extrapyramydal signs, and muscle enzyme elevations, which met the criteria for NMS. Also, they all showed hyponatremia induced by isolated ACTH deficiency. In addition to the standard therapy for NMS, corticosteroid supplement therapy was effective in all patients. There thus appear to be subjects with isolated ACTH deficiency among patients presenting with NMS-like symptoms, and adrenal and pituitary function should be checked in NMS patients with hyponatremia.
authors.affiliation: Department of Neurology, Toyoshina Red Cross Hospital.
authors.forename: Y
authors.initials: Y
authors.lastname: Sekijima
authors.forename: K I
authors.initials: KI
authors.lastname: Hoshi
authors.forename: H
authors.initials: H
authors.lastname: Kasai
authors.forename: M
authors.initials: M
authors.lastname: Okada
authors.forename: S
authors.initials: S
authors.lastname: Namiki
authors.forename: K
authors.initials: K
authors.lastname: Ohta
authors.forename: T
authors.initials: T
authors.lastname: Nakano
authors.forename: J
authors.initials: J
authors.lastname: Hirayama
authors.forename: S I
authors.initials: SI
authors.lastname: Ikeda
mesh_terms: D000324:Adrenocorticotropic Hormone / Q000172:deficiency*; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009459:Neuroleptic Malignant Syndrome / Q000175:diagnosis / Q000209:etiology*
chemical_list: D000324:Adrenocorticotropic Hormone