Abstract
We report a male patient who presented with severe fasting hypoglycemia in which extensive pituitary and adrenal investigations were diagnostic of isolated ACTH deficiency of pituitary origin. The finding of autoimmune subclinical primary hypothyroidism strongly suggested an autoimmune etiology of the pituitary disease. Lymphocytic hypophysitis, although very rare in male patients, has to be kept in mind when studying patients with pituitary failure of unknown origin, especially when other autoimmune endocrinopathy is present.
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Orme S.M., Belchetz P.E. Isolated ACTH deficiency. Clin. Endocrinol. (Oxf.) 35: 213, 1991.
Guay A.T., Agnello V., Tronic B.C., Gresham D.G., Freidberg S.R. Lymphocytic hypophysitis in a man. J. Clin. Endocrinol. Metab. 64: 631, 1987.
Pestell R.G., Best J.D., Alford F.P. Lymphocytic hypophysitis. The clinical spectrum of the disorder and evidence for autoimmune pathogenesis. Clin. Endocrinol. (Oxf.) 33: 457, 1990.
Spagnolli W., De Venuto G., Mattarei M., Ramponi C., Dal Folio M., Miori R. Isolated ACTH deficiency: description of a clinical case. Recenti Prog. Med. 81: 499, 1990.
Komatshu M., Aizawa T., Shinoda T., Yamada T., Mochizuki T. ACTH deficiency and TSH hypersecretion in a patient with empty sella turcica. Am. J. Med. Sci. 297: 186, 1989.
Aanderud S., Jorde R. ACTH deficiency, hyperprolactinemia and benign intracraneal hypertension. Acta Endocrinol. (Copenh.) 118: 346, 1988.
Gordon D., Beastall G.H., Thomson C., Thomson J.A. ACTH deficiency hypothalamic or pituitary in origin. Scot. Med. J. 32: 49, 1987.
Jensen M.D., Handberger B.S., Scheithauer B.W., Carpenter P.C., Mirakian R., Banks P.M. Lymphocytic hypophysitis with isolated corticotropin deficiency. Ann. Intern. Med. 105: 200, 1986.
Bevan J.S., Othman S., Lazarus J.H., Parkes A.B., Hall R. Reversible adrenocorticotropin deficiency due to probable autoimmune hypophysitis in a woman with postpartum thyroiditis. J. Clin. Endocrinol. Metab. 74: 548, 1992.
Giustina A., Candrina R., Cimino A., Romanelli G. Development of isolated ACTH deficiency in a man with type I diabetes mellitus. J. Endocrinol. Invest. 11: 375, 1988.
Dewailly D., Bourdelle-Hego M.F., Pouplard-Barthelaix A., Fossati P. Recovery of ovulatory menstrual cycles under hydrocortisone in two amenorrheic female with isolated corticotropin deficiency. Horm. Res. 29: 14, 1988.
Shimatsu A., Suzuki Y., Tanaka S. Gynecomastia associated with isolated ACTH deficiency. J. Endocrinol. Invest. 10: 127, 1987.
Shibutani Y. Prolactin dynamics in a patient with isolated ACTH deficiency accompanied by hyperprolactinemia. Am. J. Med. Sci. 295: 140, 1988.
Kamijo K., Saito T., Kato M., Kawasaki K., Yachi A. Reports of two cases of selective adrenocorticotropin (ACTH) and growth hormone (GH) deficiency: differential diagnosis from cases with isolated ACTH deficiency associated with GH insufficiency. Endocrinol. Jpn. 36: 781, 1989.
Miller M.J., Vander Horst T. Isolated ACTH deficiency and primary hypothyroidism. Acta Endocrinol. (Copenh.) 99: 573, 1982.
Cosman F., Post K.D., Holub D.A., Wardlaw S.L. Lymphocytic hypophysitis. Report of 3 new cases and review of the literature. Medicine 68: 240,1989.
Skanes V., Barnard J., Farid N., Marshall W.H., Murphy L., Rideout D., Taylor R., Xiclos G., Larsen B. Class III alelles and high risk MHC aplotypes in type I diabetes mellitus, Graves’ disease and Hashimoto’s thyroiditis. Mol. Biol. Med. 3: 143, 1986.
Lever E.G., McKerron C.G. Auto-immune Addison’s disease associated with hyperprolactinemia. Clin. Endocrinol. (Oxf.) 21: 451, 1984.
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Escobar-Morreale, H., Serrano-Gotarredona, J. & Varela, C. Isolated adrenocorticotropic hormone deficiency due to probable lymphocytic hypophysitis in a man. J Endocrinol Invest 17, 127–131 (1994). https://doi.org/10.1007/BF03347700
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DOI: https://doi.org/10.1007/BF03347700