- A Case of Ioslated TSH Deficiency.
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Hyun Kim, Won Seob Kim, Soo Jin Choi, Dong Yoon Kim, Se Hyun Kim, Seung Min Park, Wan Koo Lee, Young Nam Kim
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J Korean Endocr Soc. 1999;14(2):392-395. Published online January 1, 2001
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- Although complete or partial deficiency of anterior pituitary hormone is well known,but isolated TSH deficiency is relatively rare throughout the world. Hypothyroidism due to isolated TSH deficiency is diagnosed by 1)symptoms or signs of thyroid deficiency, 2)demonstration of an absent or impaired TSH response to TRH stimulation, 3)intact other pituitary hormones. We report a case of hypothyroidism due to isolated TSH deficiency. The patient was 75 years old man and his complaints were generalized edema and weight gain. On laboratory study, T3, T4, TSH was low and TSH response to TRH stimulation was blunted, but other piutuitary hormones were intact. After thyroxine replacement, TFT and his symptoms were recovered.
- A Case of Isolated ACTH Deficiency Manifestated by Atrial Fibrillation and Hypoglycemia.
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Won Seob Kim, Ki Se Lee, Sun Kyung Song, In Suk Seo, Soo Jin Choi, Dong Yoon Kim
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J Korean Endocr Soc. 1998;13(4):646-651. Published online January 1, 2001
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- Isolated ACTH deficiency is a rare cause of secondary adrenocortical insufficiency caused by the defect of synthesis or release of ACTH in pituitary gland. The clinical presentation can be simiilar to that of primary adrenal insufficiency, but there is a greater tendency for hypoglycemia and absence of hyperpigmentation. The patient, 80 year-old female, was admitted in chief complaint of deteriorated mental states. On admission, serum sodium was 127mEq/L, potassium 4.4mEq/L, blood glucose 27mg/dL and on routine E.C.G. was atrial fibrillation was revealed. The basal morning serum cortisol level was 9.97 pg/dL it dosent respond to insulin-induced hypoglycemia enoughly, but other pituitary functions were intact in pituitary cocktail stimulation test. In CRH stimulation test, there was no remarkable response in serum ACTH and cortisol level. Brain MRI failed to reveal any anatomic abnormalities of the sellar or suprasellar area consistent with the defect of pituitary ACTH secretion. This case was a isolated ACTH deficiency, So, we conclude that associated with atrail fibrillation and hypoglycemia.
- A Case of Cerebral salt Wasting Syndrome with Pseudomonas Meningitis after Removal of Pituitary Adenoma.
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Dong Yoon Kim, Byung Yi Ahn, Duk Soo Cho, Se Hwa Kim, Kwi Wan Kim, Jong Phil Eun
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J Korean Endocr Soc. 1997;12(4):609-613. Published online January 1, 2001
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- Hyponatremia is frequently seen in intracranial hemorrhagic patients and has been often attributed to inappropriate secretion of antidiuretic hormone. But in recent years, a number of studies have shown that hyponatremia in many patients with intracranial disease may actually be caused by cerebral salt wasting (CSW) syndrome and circulating Atrial natriuretic peptide (ANP) and Brain natriuretic peptide (BNP) are probably involved. This report describes a patient who developed bacterial meningites caused by pseudomonas aeruginosa and CSW syndrome after removal of pituitary adenoma. CSW syndrome resolved by fluid and salt replacement after 4 months.
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