title: Isolated adrenocorticotropin deficiency associated with delirium and takotsubo cardiomyopathy.
abstract: We report a 65-year-old woman with isolated adrenocorticotropic hormone (ACTH) deficiency. The patient was transported to the emergency outpatient department by ambulance complaining of malaise and nausea. Because her laboratory data revealed hyponatremia, we performed endocrinological examinations and diagnosed isolated ACTH deficiency. After admission, she went into a delirious state and suffered from takotsubo cardiomyopathy due to adrenal insufficiency. Replacement therapy with hydrocortisone sufficiently improved her delirium and cardiomyopathy. We conclude that her unstable mental state and myocardial dysfunction were closely related to adrenal insufficiency and suggest that adrenal crisis may cause delirium and Takotsubo cardiomyopathy.
authors.affiliation: Department of Endocrinology and Metabolism, Tokyo Metropolitan Health Medical Treatment Corporation Toshima Hospital, 33-1 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan.
authors.forename: Masanori
authors.initials: M
authors.lastname: Murakami
authors.forename: Noriko
authors.initials: N
authors.lastname: Matsushita
authors.forename: Rie
authors.initials: R
authors.lastname: Arai
authors.forename: Naohiro
authors.initials: N
authors.lastname: Takahashi
authors.forename: Ryuki
authors.initials: R
authors.lastname: Kawamura
authors.forename: Sayaka
authors.initials: S
authors.lastname: Suzuki
authors.forename: Sachio
authors.initials: S
authors.lastname: Takekawa
authors.forename: Fumiko
authors.initials: F
authors.lastname: Iwashima
authors.forename: Takashi
authors.initials: T
authors.lastname: Shibui
authors.forename: Akihiro
authors.initials: A
authors.lastname: Hata
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Ogawa
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Horiuchi