title: Isolated adrenocorticotropic hormone deficiency with transient thyroiditis inducing an adrenal crisis.
abstract: OBJECTIVE
  It was the aim of this study to describe a patient with isolated adrenocorticotropic hormone deficiency presenting with a variety of involuntary movements who developed an adrenal crisis due to transient thyroiditis.
  
  
  METHODS
  A 61-year-old man was hospitalized with a variety of involuntary movements that were suspected manifestations of metabolic encephalopathy. After admission, his general status rapidly deteriorated to a life-threatening condition that included a degree of hyponatremia. The hyponatremia and metabolic encephalopathy provided clues toward a definitive diagnosis. After corticosteroid and sodium supplementation improved the status of the patient, endocrinological examinations revealed that he suffered from isolated adrenocorticotropic hormone deficiency followed by transient thyroiditis that induced an adrenal crisis.
  
  
  CONCLUSIONS
  This case emphasizes the importance of considering hypoadrenalism when encountering hyponatremia or metabolic encephalopathy of unknown etiology.
authors.affiliation: First Department of Medicine, Osaka Medical College, Takatsuki City, Osaka, Japan. in1149@poh.osaka-med.ac.jp
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Hiraiwa
authors.forename: Daisuke
authors.initials: D
authors.lastname: Furutama
authors.forename: Sadaki
authors.initials: S
authors.lastname: Sakane
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Ito
authors.forename: Akihisa
authors.initials: A
authors.lastname: Imagawa
authors.forename: Fumiharu
authors.initials: F
authors.lastname: Kimura
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Hanafusa
mesh_terms: D000208:Acute Disease; D000309:Adrenal Insufficiency / Q000175:diagnosis*; D000324:Adrenocorticotropic Hormone / Q000172:deficiency*; D003937:Diagnosis, Differential; D006801:Humans; D007010:Hyponatremia / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D013966:Thyroiditis / Q000175:diagnosis*
chemical_list: D000324:Adrenocorticotropic Hormone