Isolated Adrenocorticotropin Deficiency Associated with Painless Thyroiditis: A Case Report and Review of the Literature
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- MIZOKAMI TETSUYA
- Division of Endocrinology and Metabolism, St. Mary’s Hospital
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- ITOH YOUHEI
- Division of Endocrinology and Metabolism, St. Mary’s Hospital
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- SATO YUICHI
- Division of Endocrinology and Metabolism, St. Mary’s Hospital
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- NUNOI KIYOHIDE
- Division of Endocrinology and Metabolism, St. Mary’s Hospital
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- OKAMURA KEN
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University
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A 53-year-old Japanese man was admitted with a 3-month history of transient headache followed by general fatigue and weight loss. He had a history of ocular myasthenia gravis which had been in remission following thymectomy 30 years ago. He had a small diffuse goiter without tenderness, and was diagnosed as having painless thyroiditis with mild thyrotoxicosis on admission. Endocrinological studies showed he had isolated adrenocorticotropin deficiency. Magnetic resonance imaging of the pituitary gland revealed no abnormalities. His symptoms improved soon after replacement of glucocorticoid. After an episode of hypothyroidism, he spontaneously became euthyroid. It is likely that thyrotoxicosis uncovered adrenal insufficiency that had developed insidiously, and hypoadrenocorticism-induced immunological changes may have triggered the development of painless thyroiditis. Moreover, thymectomy might have facilitated the development of pituitary and thyroid autoimmunity.
収録刊行物
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- Ｔｈｅ Ｋｕｒｕｍｅ Ｍｅｄｉｃａｌ Ｊｏｕｒｎａｌ
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Ｔｈｅ Ｋｕｒｕｍｅ Ｍｅｄｉｃａｌ Ｊｏｕｒｎａｌ 59 (3.4), 71-77, 2012
久留米大学医学部 The Kurume Medical Journal 編集部