Isolated ACTH deficiency associated with Crohn's disease

dc.contributor.authorKalambokis, G.en
dc.contributor.authorVassiliou, V.en
dc.contributor.authorVergos, T.en
dc.contributor.authorChristou, L.en
dc.contributor.authorTsatsoulis, A.en
dc.contributor.authorTsianos, E. V.en
dc.date.accessioned2015-11-24T19:08:45Z
dc.date.available2015-11-24T19:08:45Z
dc.identifier.issn0391-4097-
dc.identifier.urihttps://olympias.lib.uoi.gr/jspui/handle/123456789/20584
dc.rightsDefault Licence-
dc.subjectAdrenocorticotropic Hormone/*deficiencyen
dc.subjectAdulten
dc.subjectAnorexia/etiologyen
dc.subjectAnti-Inflammatory Agents/therapeutic useen
dc.subjectCrohn Disease/*complicationsen
dc.subjectDiarrhea/etiologyen
dc.subjectFatigueen
dc.subjectHemodynamicsen
dc.subjectHumansen
dc.subjectHydrocortisone/therapeutic useen
dc.subjectMaleen
dc.subjectWeight Lossen
dc.titleIsolated ACTH deficiency associated with Crohn's diseaseen
heal.abstractWe report a case of a 37-yr-old man with a 11-yr history of Crohn's disease (CD), who presented with mucous diarrheas of 1-week duration and a 3-month history of anorexia, increasing fatigue and weight loss of 7 kg. The patient was treated with sulfasalazine 3 g/day until 2 weeks prior to the present admission, when he reduced the dose to half as he considered the drug responsible for his symptoms. Despite aggressive iv rehydration and resolution of diarrheas with an increase in sulfasalazine dose, the patient remained hemodynamically unstable, while laboratory results showed anemia, hypoglycemia, hypertransaminasemia and hyponatremia with marked natriuresis. Thyroid function tests were consistent with primary hypothyroidism, without evidence of autoimmunity. Further laboratory investigation revealed a low basal cortisol and undetectable ACTH with preserved secretory responses of the other trophic pituitary hormones, establishing the diagnosis of isolated ACTH deficiency. Hydrocortisone replacement treatment induced a clinical and laboratory improvement. The autoimmune basis of isolated ACTH deficiency is discussed in association with the presumed contribution of immunologic reactions in the pathogenesis of CD. However more evidence is needed before isolated ACTH deficiency is added to the list of extraintestinal manifestations of CD.en
heal.accesscampus-
heal.fullTextAvailabilityTRUE-
heal.identifier.secondaryhttp://www.ncbi.nlm.nih.gov/pubmed/15762046-
heal.journalNameJournal of Endocrinological Investigationen
heal.journalTypepeer-reviewed-
heal.languageen-
heal.publicationDate2004-
heal.recordProviderΠανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικήςel
heal.typejournalArticle-
heal.type.elΆρθρο Περιοδικούel
heal.type.enJournal articleen

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