Isolated ACTH is a rare cause of secondary adrenocortical insufficiency. The diagnosis is made by the demonstration of low cortisol production with low plasma ACTH, absent adrenal responses to stimulation for pituitary or hypothalamus with intact adrenal response to exogenous ACTH, and normal secretory indices of other pituitary hormones. We conclude that the diagnosis of this condition may be difficult due to the varied clinical presentation and etiologies.

1.
Irvine WJ, Barnes EW: Adrenocortical insufficiency. Clin Endocrinol Metab 1972;1:549–594.
2.
Littley MD, Gibson S, White A, Shalet SM: Comparison of the ACTH and cortisol responses to provocative testing with glucagon and insulin in normal subjects. Clin Endocrinol 1989;31:527–553.
3.
Numa S, Imura H: ACTH and related peptides: Gene structure and biosynthesis; in Imura H (ed): The Pituitary Gland. New York, Raven Press, 1985, pp 83–102.
4.
Smith AI, Funder JW: Proopiomelanocortin processing in the pituitary, central nervous system, and peripheral tissues. Endocr Rev 1988;9:159–179.
5.
Jensen MD, Handwerger BS, Bernd WS, Scheithauer BW, Carpenter PC, Mirakien R, Andbanks PW: Lymphocytic hypophysis with isolated corticotrophin deficiency. Ann Intern Med 1986;105:200–203.
6.
Asa SL, Bilbao JM, Kovacs K, Josse RG, Kreines K: Lymphocytic hypophysitis of pregnancy resulting in hypopituitarism: A distinct clinicopathological entity. Ann Intern Med 1981;95:166–171.
7.
Gordon D, Beastall GH, Thomson C, Thomson JS: ACTH deficiency: Hypothalamic or pituitary in origin? Scott Med J 1987;32:49–50.
8.
Giustina A, Candrina R, Cimino A, Romanelli G: Development of isolated ACTH deficiency in a man with type I diabetes mellitus. J Endocrinol Invest 1988;11:375–377.
9.
Aanderud S, Jorde R: ACTH deficiency, hyperprolactinaemia and benign intracranial hypertension. Acta Endocrinol 1988;118:346–350.
10.
Fukata J, Nakai Y, Imura H: Human corticotrophin-releasing hormone test in normal subjects and patients with hypothalamic, pituitary or adrenocortical disorders. Endocrinol Jpn 1988;35:491–502.
11.
Funder JW, Smith I: Isolated ACTH deficiency: Enzyme defect or chimaeric enzyme? Clin Endocrinol (Oxf) 1993;39:385–386.
12.
Nussey SS, Soo SC, Gibson S, Gout I, White A, Bain M, Johnstone AP: Isoalated congenital ACTH deficiency: A cleavage enzyme defect? Clin Endocrinol (Oxf) 1993;39:381–385.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.