title: Isolated Adrenocorticotropin Deficiency Concomitant with Graves' Disease: A Case Report and Literature Review.
abstract: A 73-year-old Japanese woman with untreated Graves' hyperthyroidism developed glucocorticoid-induced adrenal insufficiency (AI) after a supraphysiological dose of prednisolone therapy for bronchial asthma. Days later, she had high plasma adrenocorticotropic hormone (ACTH) levels and was expected to recover from glucocorticoid-induced AI. Her plasma ACTH levels remained high over 3 months during a physiological dose of hydrocortisone replacement. However, she suffered a further decrease in her serum cortisol level and was diagnosed with isolated adrenocorticotropin deficiency (IAD), in which bioinactive ACTH likely caused the high ACTH value. IAD should be considered as an unusual disorder associated with Graves' disease, especially in older patients.
authors.affiliation: Department of Endocrinology and Metabolism, Nagaoka Red Cross Hospital, Japan.
authors.forename: Nobumasa
authors.initials: N
authors.lastname: Ohara
authors.forename: Masanori
authors.initials: M
authors.lastname: Kaneko
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Kuriyama
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Sato
authors.forename: Hideki
authors.initials: H
authors.lastname: Katakami
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Oki
authors.forename: Kenzo
authors.initials: K
authors.lastname: Kaneko
authors.forename: Kyuzi
authors.initials: K
authors.lastname: Kamoi
mesh_terms: D000309:Adrenal Insufficiency / Q000139:chemically induced* / Q000188:drug therapy / Q000503:physiopathology; D000324:Adrenocorticotropic Hormone / Q000097:blood* / Q000172:deficiency* / Q000187:drug effects; D000368:Aged; D000855:Anorexia / Q000097:blood / Q000188:drug therapy; D013956:Antithyroid Agents / Q000627:therapeutic use; D001249:Asthma / Q000188:drug therapy*; D004700:Endocrine System Diseases / Q000139:chemically induced*; D005221:Fatigue / Q000097:blood / Q000188:drug therapy; D005260:Female; D030342:Genetic Diseases, Inborn / Q000139:chemically induced*; D005938:Glucocorticoids / Q000009:adverse effects* / Q000627:therapeutic use; D006111:Graves Disease / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D006854:Hydrocortisone / Q000097:blood / Q000627:therapeutic use*; D007003:Hypoglycemia / Q000139:chemically induced*; D011239:Prednisolone / Q000009:adverse effects* / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D013956:Antithyroid Agents; D005938:Glucocorticoids; D000324:Adrenocorticotropic Hormone; D011239:Prednisolone; D006854:Hydrocortisone