ECE2020 Audio ePoster Presentations Pituitary and Neuroendocrinology (217 abstracts)
Isolated adrenocorticotropic hormone deficiency in a female with ectopic posterior hypophysis
Georgios Boutzios 1 , Eleni Koukoulioti 1 , Konstantinos Bourgalis-Michalopoulos 1 , Ilias Giovannopoulos 1 , Myrto Miliou 1 , Eleni Papaoiconomou 1 & Gerasimos Tsourouflis 2
1National and Kapodistrian University of Athens, Pathophysiology, Athens, Greece; 2National and Kapodistrian University of Athens, Second Department of Propedeutic Surgery, Athens, Greece
Introduction: Some endocrine disorders, including hypophysitis and isolated adrenocorticotropic hormone (ACTH) deficiency, are caused by an autoimmune response to endocrine organs. Previous data have also shown that isolated ACTH deficiency may be associated at least in part with a paraneoplastic syndrome. We present a rare case with isolated ACTH deficiency along with ectopic posterior hypophysis.
Case presentation: A 53-year-old woman (menopause 45 yo), non-smoker, with a history of Hashimoto thyroiditis with normal thyroid function, osteopenia and cholelithiasis presented with fatigue and weakness gradually increasing in the last two months. Laboratory tests showed low morning ACTH: 9.8 pg/ml (n.v. 7–64), cortisol: 3.1 µg/dl (n.v. 6.2–19.4), DHEAS: 11 µg/dl (35.4–256) and Testosterone: <2.5 nmol/l (20–130), increased FSH and LH levels due to menopause and normal TSH, PRL and IGF-1 levels. Plasma renin activity and aldosterone levels were also normal. A pituitary MRI was performed and showed an ectopic posterior hypophysiswithout other abnormalities. An abdominal CT revealed atrophy in both adrenals. Due to the history of autoimmune thyroid disease, IgG4and CBG levels were also estimated and found to be within normal range. The patient was treated with hydrocortisone per os and showed rapid improvement of her symptoms.
Conclusion: Although the pathogenesis of some autoimmune endocrine diseases has been elucidated, it remains obscure for most. Further evaluation for the pathogenesis of isolated ACTH deficiency is needed.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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