title: [Isolated ACTH deficiency in a late onset case of hypogonadism (LOH) not diagnosed by examination in an internal medicine clinic].
abstract: We present a case of isolated adrenocorticotrophic hormone (ACTH) deficiency (IAD) in a late onset hypogonadism (LOH) clinic, not diagnosed by examinations in internal medicine. A 54-year-old man showed body weight loss with severe appetite loss, general malaise and hypotension. He visited our clinic for a checkup for LOH after general examinations in internal medicine. His hormonal examination showed undetectable ACTH and cortisol levels. However, the values of other pituitary hormones and testosterone were normal. A load test for anterior pituitary hormone (CRH + TRH + LHRH + GRH test) revealed that the ACTH-cortisol system showed no response although the other pituitary hormones responded. These findings confirmed the diagnosis of isolated ACTH deficiency. Administration of hydrocortisone dramatically improved his symptoms. Symptoms of IAD are similar to those of LOH syndrome and depression. Thus, we should consider IAD as one of the differential diagnoses in LOH clinics.
authors.affiliation: Sanjukai Hospital.
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Sato
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Tanda
authors.forename: Shuji
authors.initials: S
authors.lastname: Kato
authors.forename: Shigeki
authors.initials: S
authors.lastname: Ohnishi
authors.forename: Hisao
authors.initials: H
authors.lastname: Nakajima
authors.forename: Toshikazu
authors.initials: T
authors.lastname: Nitta
authors.forename: Keigo
authors.initials: K
authors.lastname: Akagashi
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Hanzawa
mesh_terms: D000324:Adrenocorticotropic Hormone / Q000172:deficiency*; D047649:Andropause; D003937:Diagnosis, Differential; D006801:Humans; D006854:Hydrocortisone / Q000008:administration & dosage / Q000172:deficiency; D007006:Hypogonadism / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
chemical_list: D000324:Adrenocorticotropic Hormone; D006854:Hydrocortisone