徳島大学 教育・研究者情報データベース(EDB)

1. (英) Matsuda Hiroya / (日) 松田 宙也 / (読) まつだ ひろや

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2. 倉橋 清衛

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3. (英) Endo Furi / (日) 遠藤 ふうり / (読) えんどう ふうり

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4. (英) Masuda Shiho / (日) 桝田 志保 / (読) ますだ しほ

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5. 役割	任意
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6. (英) Mitsui Yukari / (日) 三井 由加里 / (読) みつい ゆかり

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7. 吉田 守美子

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8. (英) Akehi Yuko / (日) 明比 祐子 / (読) あけひ ゆうこ

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9. 遠藤 逸朗([徳島大学.大学院医歯薬学研究部.保健学域.保健科学部門.医用検査学系.生体機能解析学])

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10. 福本 誠二

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(英) A case of isolated ACTH deficiency that required 6 months for the diagnosis from onset.

(日) 症状発現から診断までに半年を要したACTH単独欠損症の一例

(日) A 53-year-old man noticed anorexia, nausea, and arthralgia of the upper limbs in April, 201X. Since these symptoms persisted, he visited general hospital and clinic and was examined for blood chemistry, ECG, echocardiography and so on. However, he did not get a definitive diagnosis and was followed up with drip infusion of saline. The symptoms did not subside and fatigue and syncope with hypotension developed. Furthermore, he also suffered weight loss of 10 kg in few months and was referred to our hospital for more detailed examinations in October, 201X. Upon the initial examination, all his symptoms matched those of adrenal insufficiency and notable decreases of both plasma ACTH and serum cortisol level were observed. Prompt glucocorticoid supplementation improved his symptoms and the abnormal laboratory data immediately. He was diagnosed adrenal insufficiency due to isolated ACTH deficiency from the results of CRH loading test and insulin tolerance test. Since most of the symptoms and laboratory findings are non-specific, diagnosis of adrenal insufficiency is often delayed. However, adrenal insufficiency could worsen when the patient is under stress (e.g. infection) and often be life-threatening. Glucocorticoid replacement therapy should be initiated as soon as the diagnosis is confirmed. Furthermore, educating patients and his families plays a very important role in the management of chronic adrenal insufficiency, in particular to the prevention of adrenal crisis.

1. (英) isolated ACTH deficiency
2. (英) adrenal insufficiency
3. (英) anorexia
4. (英) nausea
5. (英) arthralgia

1. 倉橋 清衛