Vincenzi P, Francia G, Dorizzi R, Pedrazzoli R, Lazzarin M
Divisione di Medicina Generale, Ospedale di Nogara, Verona.
Minerva Endocrinol. 1992 Jul-Sep;17(3):127-31.
In a 46 year old man, who arrived at our observation suffering for three months from considerable increasing weakness and progressive impairment of libido, we documented a condition of secondary hypocorticism due to an isolated ACTH deficiency associated with a reduced somatotropin reserve, the last improved after treatment with corticosteroids. We found low serum levels of ACTH and cortisol, good response of adrenal glands to corticotropin depot, normalization of the clinical board during glucocorticoid replacement. Stimulating test with CRH (corticotropin releasing hormone) did not cause a response in ACTH, suggesting the presence of primitive damage of the hypophyseal corticotroph cells.
一名46岁男性患者,因持续三个月的明显肌无力加重及性欲进行性减退前来我院就诊。我们记录到该患者存在继发性肾上腺皮质功能减退,病因是孤立性促肾上腺皮质激素(ACTH)缺乏,并伴有生长激素储备减少,在接受皮质类固醇治疗后生长激素储备有所改善。我们发现患者血清ACTH和皮质醇水平较低,肾上腺对长效促肾上腺皮质激素反应良好,在糖皮质激素替代治疗期间临床症状恢复正常。促肾上腺皮质激素释放激素(CRH)刺激试验未引起ACTH反应,提示存在垂体促肾上腺皮质激素细胞原发性损伤。