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Exp Clin Endocrinol Diabetes 2023; 131(10): 523-531
DOI: 10.1055/a-2135-7708
Article

Idiopathic Isolated Adrenocorticotropic Hormone Deficiency: A Single-Center Retrospective Study

Chengyan Yang
1   Shandong First Medical University, Jinan, China
,
Xinpei Li
2   Jining Medical University, Jining, China
,
Xiaoqing Ma
3   Jining No 1 Peopleʼs Hospital, Jining, China
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Abstract

Idiopathic isolated adrenocorticotrophic hormone deficiency (IIAD) is rare, with high clinical omission and misdiagnosis rates. This study retrospectively collected information on clinical presentation, laboratory findings, and treatment response of 17 patients with IIAD at Jining No. 1 People's Hospital from January 2014 to December 2022. The clinical characteristics were summarized, and the pertinent data were analyzed. As a result, most of the patients with IIAD were male (94.12%), with age at onset ranging from 13 to 80 years. The primary manifestations were anorexia (88.24%), nausea (70.59%), vomiting (47.06%), fatigue (64.71%), and neurological or psychiatric symptoms (88.24%). The median time to diagnosis was 2 months and the longest was 10 years. Laboratory tests mostly showed hyponatremia (88.24%) and hypoglycemia (70.59%). The symptoms and laboratory indicators returned to normal after supplementing patients with glucocorticoids. IIAD has an insidious onset and atypical symptoms; it was often misdiagnosed as gastrointestinal, neurological, or psychiatric disease. The aim of this study was to improve clinicians' understanding of IIAD, patients with unexplained gastrointestinal symptoms, neurological and psychiatric symptoms, hyponatremia, or hypoglycemia should be evaluated for IIAD and ensure early diagnosis and treatment.

Key words

idiopathic isolated adrenocorticotrophic hormone deficiency - pathogenesis - clinical features - diagnosis - treatment and prognosis


Publication History

Received: 08 April 2023
Received: 08 July 2023

Accepted: 14 July 2023

Article published online:
08 September 2023

© 2023. Thieme. All rights reserved.

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