title: Type 1 diabetes mellitus and isolated adrenocorticotropin deficiency manifested by parkinsonism: a case report and literature review.
abstract: A 67-year-old woman developed isolated adrenocorticotropin deficiency (IAD), which manifested as lethargy, a 20-kg body weight loss, hypoglycemia, and parkinsonism, and began corticosteroid replacement. Her symptoms resolved rapidly, and her weight returned to normal within six months. However, she then developed slowly progressive type 1 diabetes mellitus (T1D) with co-existing Hashimoto thyroiditis, and commenced insulin therapy. To our knowledge, this is the first reported case of parkinsonism associated with IAD. In addition, because diabetes mellitus, including T1D, could be latent in patients with untreated IAD, careful assessment of glucose metabolism is needed after commencing corticosteroid replacement until weight regain is achieved.
authors.affiliation: Department of Endocrinology and Metabolism, Niigata Medical Center, Japan.
authors.forename: Nobumasa
authors.initials: N
authors.lastname: Ohara
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Kojima
authors.forename: Takashi
authors.initials: T
authors.lastname: Sato
authors.forename: Tomoo
authors.initials: T
authors.lastname: Ikarashi
authors.forename: Hirohito
authors.initials: H
authors.lastname: Sone
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Oki
authors.forename: Kyuzi
authors.initials: K
authors.lastname: Kamoi
authors.forename: Masao
authors.initials: M
authors.lastname: Hara
authors.forename: Hideo
authors.initials: H
authors.lastname: Sasaki
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000324:Adrenocorticotropic Hormone / Q000172:deficiency*; D000368:Aged; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000188:drug therapy; D004700:Endocrine System Diseases / Q000150:complications* / Q000188:drug therapy; D005260:Female; D030342:Genetic Diseases, Inborn / Q000150:complications* / Q000188:drug therapy; D005947:Glucose / Q000378:metabolism; D050031:Hashimoto Disease / Q000150:complications*; D006801:Humans; D007003:Hypoglycemia / Q000150:complications* / Q000188:drug therapy; D007328:Insulin / Q000627:therapeutic use; D020734:Parkinsonian Disorders / Q000150:complications*
chemical_list: D000305:Adrenal Cortex Hormones; D007328:Insulin; D000324:Adrenocorticotropic Hormone; D005947:Glucose