Isolated adrenocorticotropic hormone deficiency with transient thyroiditis inducing an adrenal crisis.
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.
Hiraiwa
Tetsuya
T
First Department of Medicine, Osaka Medical College, Takatsuki City, Osaka, Japan. in1149@poh.osaka-med.ac.jp
Furutama
Daisuke
D
Sakane
Sadaki
S
Ito
Mitsuru
M
Imagawa
Akihisa
A
Kimura
Fumiharu
F
Hanafusa
Toshiaki
T
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*
D000324:Adrenocorticotropic Hormone