Abstract
This case study describes a 33-year-old man with Addison’s disease who presented with increased plasma adrenocorticotropic hormone (ACTH), normal plasma cortisol, and absent diurnal rhythms. Magnetic resonance imaging (MRI) indicated pituitary hyperplasia. Conventional hydrocortisone replacement therapy may not inhibit high ACTH levels in the morning; however, replacing hydrocortisone with dexamethasone achieved good therapeutic results.
This is a preview of subscription content, log in via an institution to check access.
References
T. Kubota, M. Hayashi, M. Kabuto et al., Corticotroph cell hyperplasia in a patient with Addison disease: case report. Surg. Neurol. 37(6), 441–447 (1992)
K. Sugiyama, M. Kimura, T. Abe et al., Hyper-adrenocorticotropinemia in a patient with Addison’s disease after treatment with corticosteroids. Intern. Med. 35(7), 555–559 (1996)
K. Sekiya, H. Nawata, K. Kato et al., Diurnal rhythms of proopiomelanocortin-derived N-terminal peptide, beta-lipotropin, beta-endorphin and adrenocorticotropin in normal subjects and in patients with Addison’s disease and Cushing’s disease. Endocrinol. Jpn. 33(5), 713–719 (1986)
G.A. Wittert, J.H. Livesey, C. Florkowski et al., Acutely raised corticotropin levels in Addison’s disease are not associated with increased plasma arginine vasopressin and corticotropin-releasing factor concentrations in peripheral plasma. J. Clin. Endocrinol. Metab. 76(1), 192–196 (1993)
K. Kovacs, L. Stefaneanu, E. Horvath et al., Pituitary corticotroph adenoma in a woman with long-standing Addison’s disease: a histologic, immunocytochemical, electron microscopic, and in situ hybridization study. Endocr. Pathol. 7(1), 91–97 (1996)
S. Miyabo, K. Miyanaga, K. Kimura et al., Inappropriate secretion of adrenocorticotropin from corticotroph hyperplasia in a case of Addison’s disease. Jpn. J. Med. 29(1), 38–45 (1990)
K. Mineura, T. Goto, M. Yoneya et al., Pituitary enlargement associated with Addison’s disease. Clin. Radiol. 38(4), 435–437 (1987)
R. Clayton, A.C. Burden, V. Schrieber et al., Secondary pituitary hyperplasia in Addison’s disease. Lancet 2(8045), 954–956 (1977)
R.N. Dexter, D.N. Orth, K. Abe et al., Cushing’s disease without hypercortisolism. J. Clin. Endocrinol. Metab. 30(5), 573–579 (1970)
R.S. Gup, L.R. Sheeler, M.C. Maeder et al., Pituitary enlargement and primary hypothyroidism: a report of two cases with sharply contrasting outcomes. Neurosurgery 11(6), 792–794 (1982)
A.S. Joshi, P.D. Woolf, Pituitary hyperplasia secondary to primary hypothyroidism: a case report and review of the literature. Pituitary 8(2), 99–103 (2005)
B. Krautli, J. Muller, A.M. Landolt et al., ACTH-producing pituitary adenomas in Addison’s disease: two cases treated by transsphenoidal microsurgery. Acta. Endocrinol. 99(3), 357–363 (1982)
W.W. Hutchins, J.V. Crues 3rd, P. Miya et al., MR demonstration of pituitary hyperplasia and regression after therapy for hypothyroidism. Am. J. Neuroradiol. 11(2), 410 (1990)
A.J. Dwyer, J.A. Frank, J.L. Doppman et al., Pituitary adenomas in patients with Cushing disease: initial experience with Gd-DTPA-enhanced MR imaging. Radiology 163(2), 421–426 (1987)
W.W. Peck, W.P. Dillon, D. Norman et al., High-resolution MR imaging of pituitary microadenomas at 15 T: experience with Cushing disease. Am. J. Roentgenol. 152(1), 145–151 (1989)
J.D. Wilson, D.W. Foster, H.M. Kronenberg et al., Williams textbook of endocrinology, 9th edn. (WB Sanders, Philadelphia, 1998), pp 547–563
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Zhou, J., Ruan, L., Li, H. et al. Addison’s disease with pituitary hyperplasia: a case report and review of the literature. Endocr 35, 285–289 (2009). https://doi.org/10.1007/s12020-009-9179-x
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12020-009-9179-x